HomeMy WebLinkAboutApplicationGarfield Coanty
BUILDING PERMIT
APPLICATION
RECENED
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Communlty Development Department
108 8th Street, Suite 401
Glenwood SPrings, CO 81601
(e7ol e45-82L2
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INVOLVED PARTIES
Property Owner:iç<otr Phone:1Qf o
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Email Address:
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Manufactured Home lnstal Phone :T
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Manufactured Home le or Multi
Residential (SF, Duplex orTownhome)
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Contractor:
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Email Address: â-
PhoneArchitect:
Mailing Address
Ema resS:
Email Address:
Phone: (_)Engineer
Mailing
)Fl.qePair Move/RelocationE ¡ddition! AlterationNew!Class of Work:
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PROJECT DETA¡tS
Describe Work:LOVLT rô" t *ilJ.0 'Lo\r-arrLk J-r^- /
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Job Address lz- I '6¡,/*-o fAc B^^J
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Assessor's Parcel Number:
Sub.Lot _ Block
Owne r's Valuation of Work: S Property Size (Sq. Ft, or Acres):
Sq. Ft. of Building: Height:# of Floors:_
i pno¡¡ct DETAILS coNTINUED
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Sept¡c:OWTS Community
Propane
Permit #:
NOTICE
Authoritv This application for a Building Permit must be signed by the Owner of the property, described above,
or an auth orized agent. lf the signature below is not tha t 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'
Other permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(¡) .not¡"¡- 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 180 days
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 Application and that the information contained above is true and correct' I
understand that the Buildirrg 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 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 regulatio ns (County Regulation(s)). I acknowledge that the
Building Permit may be suspended or revoked, upon notice from the County, if the location, construct¡on 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 ner,or builder
I hereby acknowledge th at I have read and understand the Notice and Certification above, as well as, have
provid uired information which is correct and accurate to the best of my knowledge
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Property Owner Print and Sign Date
OtherElectricNatural GasType of Heat:
ExemptDriveway Permit:
dtM-/OFFICIAL USE ONLY
Special Conditions:
e FeeManuôk Fee:PlanValuation:Adj
OWTS No:BPnce D öbPaæTotals/0ôo
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BUILDING / PLANNING DIVISION :
Signed Approval