HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPTICATIONCommunity Development Department
108 8th Street, Suite ¿101
Glenwood Springs, CO 81601
l970l94s-82t2
www.garf iel d-cou ntv. com
TYPE OF COÍ{STRUCÍION
Commercial/Multi-Fami Demolition
Manufactured Home or Multi-Level
ex or TownResidential
INVOTVED PARNES
Propefi Owner:
Mailing Address:
Phone: ( )
Email Address:
-
Manufactured Home lnstaller: Phone:
Mailing Address:
Email Address:
Email Address:
37¡
lzpPhone:
r>
Q.^,-,tezR,D S '+¿3qtMailing Address
Contractor:
Architect: Phone
Mailing Address:
Email Address:
t)
Engineer:
Mailing Address:
Email Address:
¡€
PROJECTDETAITS
Describe Work:
I c-e- !-
Job Address:q
Assessol's Parcel Number:
5ub.
Owne/s Valuation
Sq. Ft. of Building:
[Å)0 SÅ.
Lot _ Block
of Work¡ô Property Size (Sq. Ft. or Acres):
Height:# of Floors:_
RepairClass of Work:New
Garage:Attached
Alteration Addition
Detached
Move/Relocation
t--pno¡sEf oriÄu cour¡ilutg
Septic:n OWTS
Type of Heat:Natural Gas
Driveway Permlt:Exempt
Communíty
Permít f:
flotner! etectric-fferopane
NOTTCS
Authoritv. This a pplication for a Building Permit must be signed bY the Owner of the propefi, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application'
Legal Access. A Building permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division'
btner perm¡ts. Multiple separate p"rtitt may be required: (1) State Electrical Permi! (2) County oWIS Permit'
(3) another permit required for use on the property identified above, e.g' state or county Highway/ Road Access
or a State Wastewater Discharge Permit'
void permit. A Building permii 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' _
.CERTIFICåTION
I hereby certifY that I have read this Appl ication and that the informati on contained above is true and correct. I
understand that the Building Division acce pts 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
complete ness of the submittais and approvai of this Applì cation, a Building Permit will 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 th e Building Permit, I agree that I and my agents will
comply with Provi sions of any federal, state or local law regu lating the work and the Garfield County Building
Code, OWTS regulatio ns and applicable land use regulations (County Regulation(s)). I acknowledge that the
Building Permit maY be suspended or revoked, upon notice from the County, if the location, construction or use
of the structure(s) and facility(ies),described above, are not in comPl iance with County Regulation(s) or any
other applicable law'
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove'toinspectthework' 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 an¡ 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
desi e or builder.
I hereby acknowl edge that I have read and understand the Not¡ce and Certification above, as well as, have
provided the which is correct and accurate to the best of my knowledge'
7*23-/
Property Sign Date
otrrcnt usË oNLY
Special Conditions:
Misc Fees:Manu home Fee:Permit Fee:Plan Check Fee:Adjusted Valuation:
OWTS No:
-5 7
Balance Due:*"/l'ð'Total Fees:
Zoning:Const Type:OCC GrouP:Setbacks:
BUTTDING / PI-ANNING DlvlsloN:
Signed APProval Date
7â
