HomeMy WebLinkAboutApplicationGørfield County
BUILDING PERMIT
APPLICATIONCommunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(97Ols4s-82L2
www.garfield-countv.com
WPE OF CONSTRUCflON
E Commercial/Multi-Family f,l Demolition
E Manufactured Home (Sincle or Multi-Level)
f l Residential (SF, DuplexorTownhome)Reroof
INVOLVED PARTIES
Phone: t f{O | 37'l - 3a< L
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Property Owner:
Mailing Address:€
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Email Address:
contractor: Al*U ùu-.*,.t R, H'yPhone:/ä -t¿("
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EmailAddress:
Mailing Address
Archltect:
EmailAddress:
Phone: I )Engineer:
Mailing
Email Address:
PhonelManufactured Home Install
Mailing
owne/s valuation of work: SW% è'\ 1fÕ ¡r<ør^e'
PROJECT DETAITS
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Sq. Ft. of Building # of Floors:
,(Describe
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Lot
Height:
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4
L.
Block
Property Size (Sq. Ft. or Acres):
Job Address:
Assessor's Parcel Number:
Sub.
New Alteration L l Rdd¡tion .ffinePair l ] Move/nelocationClass of Work:
l ] DetachedGarage!Attached
PROJECT DETAITS CONT¡NUED
Septic:OWTS
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as we!I as, have
the uired information which is correct and accurate to the best of my knowledge'
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Property Owner Print and Sign Date
I
! Community
Other! eropane l_l ElectricType of Heat:I I Natural Gas
Driveway Permit: l! rxempt
I
llPermit#:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be províded with this Application.
Lesal Access. ABuildingPermitcannotbeissuedwithoutproof of legalandadequateaccesstothepropertyfor
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wâstewater Discharge Permit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
above,
I hereby certify that I have read this Application and that the information contained above is true and correct. I
understand that the Building Division accepts the Application, along with the plans and specifications and other
data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of thisApplication, a Building Permitwill be issued granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by
the Building Division, ln consideration of the issuance of the Building Permit, lagree that land my agents will
comply with provisions of any federal, state or local law regulating the work and the Garfield County Building
Code, OWTS regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the
Building Permit may be suspended or revoked, upon notice from the County, lf the locat¡on, construction or use
of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any
other applicable law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping
construction or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other
applicable law. Review of this Application, including submittals, and inspections of the work by the Building
Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
designer, engineer and/ or builder.
OFFICIAT USE ONtY
Special Conditions:
Misc Fees:
\ò /l\Permit Fee:
Atm.oo
Manu home Fee:
f\\ lftAdjusted Valuation:N\/t\Plan Check Fee:
tr,..\ / ll
OWTS No:f.ì/Â#a ØBalance Due:BP No:
zu)F-y)st'#ìB'*Påid:
OOü.
Fees
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Zonin!:
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Const Type:ne-Setbacks:\\ IA OCC Group:I?'c-
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