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HomeMy WebLinkAboutApplicationGurfield County BUILDING PERMIT APPLICATIONRECElVEbmmunity Development Department 1OB 8th Street, Suite 401 SËt, i 2 2ü18 Glenwood Springs, co 81601 G A ft SIFY B'vc8ypilü-- (:];1ff :.':Íli'"' TYPE OF E Demolition hJÅTeltlÀ 5t6'l Phone: ,3lo I ç4L-:ILb4 Email Address:vla{r*çhag ÞÞ nnai I , (ÅttJ Manufactured Home lnstaller: Phone: PROJECT DETAITS Commercial/Multi-Fami Property Owner;úWRTJ E Mailing Address:lsi Mailing Address: Email Address: ...kàvt .J"*ad Describe Work: ,ñeþLrtt r'e<tF €er wr.a,pfu¿1 Job Address:â Assessor's Parcel Number: Sub. Owne/s Valuation of Work:w Lot - Block Property Size (Sq. Ft, or Acres)*û t/- Height:*ortrr¡orsz 7- Manufactured Home or Multi-Level l--l ReroofÑ Residential (SF, DuPlex or Townhome) Mailing Address: Email Address:f[d-,¿eS, c¿O¡ 7-56a (Ôt*(1 Phone \N(Ðh Contractor:l-ffi-tFtfr Mailing Address:æ+ Arch¡tect:rfn tt 9tb1+(00. - ¿ert\ô.,{roh{ Phone: Email Address: Engineer: Phone: (-)-- Mailing Address: Email Address: I Repair i L ¡ LlRd¿¡t¡onNew!Eþtr"r",ionClass of Work: !RttachedGarage: Sq. Ft. of Building:4 t?c,/ Detached Move/Relocation PROJ ECT DETAII.S CONTINU ED Sept¡c:OWTS Natural Gas KLProprn" I Community Electric Other Permit #: - Type of Heat Driveway Perm¡t:Exempt NOTICE Author¡W. This aPPlicatio n for a Building Permit must be signed by the Owner of the property, described above, , a separate letter of authority, signed byor an authorized agent. lf the signature below is not that of the Owner 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. Other permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit, (¡) .nott'"¡. permit required for use on the property identified above, e.g. State or County Highway/ Road Access or a State Wastewater Discharge Permit. Voidpermit. ABuildingpermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICATION I hereby certify that I have read this Appli cation 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 subm¡ttals and approval of th is Application, a Building Permit will be issued granting permission to me, as Owner, to construct the structu re(s) and facilities detailed on the submittals reviewed by the Building Division. ln consideration of the issuance of the Building Permit, I agree that I and 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 regulat ions (County Regulation(s)). I acknowledge that the Building Permit may be suspended or revoked, upon noti ce from the County, if the location, 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 Q-esig,¡g¡, -e_¡gi1e_e¡ a¡!/ 9¡ bu!!!9r, I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have ¡nformation which is correct and accurate to the best of my knowledge' 1'/:)-/8 Print and Sign Date dr,<L +ıt{ l? s7t.ool-)OFFICIAL USE ONLY ISpecial Conditions: 'Manu home Fee v//\''*'"F17A ( Permit Fee: {25.¿oPláîCñeck Fee: rò lR OWTS No: , ^ -IJIA D¿ruto 5L+("1 BP No:Balance Due:&Fees Påid: Szs.¿"ton'nt'É-P\.OCC Group: I í:., Tt+"ktÊ, Date BUITDING / PI.ANNING DIVISION :