HomeMy WebLinkAboutApplicationGarfuld County
Community Development Department
108 8th Streeù Sulte 4ol
Glenwood SPrlngs, CO 81601
(e70) 945-8212
wr¡rnü.earf¡eld-counW.com
BUILDING PERMIT
APPLICATION
DemolitionCommercial/M u lti-Fa milY
Manufactured Home (Single or Multi-Level)
ReroofResidential tSF, Duplex or Townhome)
Unlt - MNilMUM SIZE OF FEET
OF
propertyoü,n"r, ßobett ll. 6irK Phone: l3ø3t 9q1-s'ç77
Malling Address:7o e ,Ow Va L;Ll eto
Emall Address:L
Contreetor:fin Phonc: t1Vo7 87c '?45o
MalllngAddress:
Emall Address:
6
Architect:¡th Phone:
MelllngAddress: _ .
Emall Address:
Engineer:w/ø Phone: f l
MailingAddress:
Emall Address:
M¡nufactured Home lnstaller:N/4 Phone:l I
Malllng Address:
-
Emall Address:
DEÍAILS
Descrlbe Work:oou - fo C C1
U
Job Addre*s:
Asssssor's parcet Numbcn â 31 l' 3 43' I 5 .- o t7
Sub.ut 32 Bbck_
Owne/s Valuation of Work:o Property strc (sq. Ft. o¡ Àct¿sl; -LJLílZfg
sq. Ft of Buif ains: A 8 5 L Heigtrt:* of Floors: I
o.,
Class of Work:New IX
i Garage:
t4'
Detached
Natural Gas Propane Ëlectric
' PROJECT OETAII.S CONTINUED
, Septlc:Commun¡ty
Type of Heat:Other
Driveway
Permit:
NONCE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a sepårate letter of authorþ, signed by
the Owner, must be provided with this Application.
Le¡¡l Access. A Building Permit cannot be issued w¡thout proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permlts. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
J-lPermltü:
I I hereby certify that I have read this Application and that the information conta¡ned 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 ceÊification as to accuracy. Assuming
completeness of the submittals and approval of this Applicatlon, a Buildlng Permit will be issued granting
permission to me, as Owner, to construct the structure(s) and facilitles detailed on the submittals reviewed by
the Building Division. ln consideration of the issuance of the Buildlng Permlt, I agree that I and my agents will
comply with provisions of any federal, state or local law regulating the work and thÊ Garfield County Building
Code, OWTS regulations and applicable land use regulations (County Regulatlon(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 Buílding Permlt does nst prevent the Building Official from: {1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping
construct¡on or use of the structure(s) or facility{ies} if such is ln 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 responsibllity or liability by the County of errors, omissions or
discrepancies. As the owner, I acknowledge that responsibiüty for compliance with federal, state and local laws
and County Regulations rest with me and my authorized agents, lncluding wlthout l¡mitat¡on rny architect
neer or builder.
! hereby acknowledge that I have read and understand the Notlce and Certlffcation above, as well as, heve
provided the requlred information which i¡ correct and accuretc to the best of my knowledge,
ît f 5-'2o I
Owner Print and Sign Dåtê
$ too log os LlOFFICIAL USE ONLY
Special Conditions:
Adlusted Valuation:Plan Check Fee:Pêrmit Fee:
)otne
Fee:M¡nu.
À)
Mlsc. Fæs:
,{x
Totâl Fees:Fees Pald:
tlo o.æ
Betalã9qel Ef!e:
Roor ,666t OWTS No:
rtrñ
Setbaclc:occ6roup:
tor
Const. Typer
/,ILL
Zonln¡:
BUTID|NG / PLANI{|NG DTVTSTON :
Signed Datê