HomeMy WebLinkAboutApplicationGar.fteld County
BUILDING PERMIT
APPLICATIONCommunity Development Department
RECEIVED 108 Bth Street, Suite 401
Glenwood SPrings, CO 81601
fìHP ¿ 5 2018 pTot s4s-s2tz
G ARF I E LD 6 g g ¡¡lvww.earfield'countv.com
COMMUNITY I}EVELOPMENT
Commercial/Multi-Fam
I
TYPE OF CONSTRUCTION
! Manufactured Home le or Multi-Level)
Residential SF, DU or Town
INVOLVED PARTIES
Dcmolition
Reroof
Property Owner:
Mailing Address:7q
þ rnon",( )
e ö¿ú ç¡e t,t-.' Þ f{ .
Email Address:
PROJECT DETAITS
Describe Work:
JobAddress: ?
Assessor's Parcel Number
suo. O <t f vv\(rn ,l r,L^ll,{-Lot Block
Owner's Valuation of Work: S
pëÒ
C4.
Property Size (Sq. Ft. or Acres):
é F'lo,Êe sÄìn,
()ttetns til e-¿.¿s t/t/L¿17/
Ì=--
Cc,ê,
es
-è7I
L
Phone:7toContractor:
Mailing Address
Email Address:
.81
Architect: Phone:(
Mailing Address
Email Address
Phone:Engineer
Mailing Address
Email Address:
Mailing Address:
Email Address:
-
Phone: (_)Manufactured Home lnstaller:
fl neRair I I Move/RelocationNew!l_lAlteration Ll Rdd¡tionClass of Work:
| | oetached[!ÁttactreoGarage:
Sq. Ft. of Building:Height:# of Floors:_
E lectricPropaneNatural Gas
Exempt
Type of Heat:Other
Driveway Permit:Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property,described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
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,
(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 Permit becomes null and void if the work authorized is not commenced within L80 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIF¡CAT¡ON
I hereby certify that I have read this Application and that the information containe d 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 this Application, 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 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 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 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
desi er, e and/ or builder
PROJECT DETAI I.S CONTINU ED
Septic:OWTS Community
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provid ed the required information s correct accurate to the best of my knowledge.
Property Print and Sign Date
CT
OFFICIAL USE I \)#6
Special Conditions:
Adjusted Valuation:
\l,\lfi
Plan Check Fee:ñln '$i,iäioo Manu home Fee:
NlrÀ
Misc Fees:
\ñl I l\
Bi:ä"00 r-ees Þaid:Çlrn.m 'sä%ö EE-N91
[2¿!oF-
OWTS'No:
ìs )fà
Setbacks:
f$ lf'l OCC Group::r"0 -
I Const Type:-lp(,Zonins:'qiT)
I
BUILDING / PLANNING DIVISION :
Signed Approval W^