HomeMy WebLinkAboutApplicationGørfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
pTale4s-82L2
www. garfield-countv.com
TYPE OF
Commercia Demolition
SQUAREJE_Ël
PARlIES
Property o'n"lîf€v &Ëvry.r
\\Mailing Address
EmailAddress:
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Phone: (_)
Phone:
[o¿tMailing Address:
Email Address:({
Architect:
Mailing Address:
EmailAddress
Email Address:
Engineer:
Mailing Address
L r ñ€Ê[ r Phone: {
BU¡LDING PERMIT
APPLICATION
Residential Du lex or Townhome
or MuManufactured Home
Reroof
Class of Work:
Phone: (_)
PROJECT DETAITS
Describe Work:
JC:f'3
Height:
Lot
Email Address:
Sq. Ft. of Building:
Property Size (5q, Ft, or Acres):
# of Floors:_
Manufactured Home lnstaller:
Mailing Address:
Job Address:
Parcel Number:
Owner's Valuation of Work: $
5ub.
on
Garage:Attached
Remodel/Alteration
Detached
Natural Gas Electric OtherType of Heat:
Driveway
Permit:
Permit #:
PROJECT DETA¡IS CONTINUED
Septic:Community
Propane
Exempt
NOïrCE
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 180 days
of the date of ¡ssuance 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 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.
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 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 constìtute an acceptance of responsibility or liability by the County of errors, om¡ssions 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
andl or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
the req ired information which ¡s correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
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Special Conditions:
Permit tee:özq, z,É
Manu. Home Feexlt Misc. Fees:
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Fees Paid:
+ ¿5r.al
Balance Due:
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BP No:
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OWïS Norx/s
Adiusted Valuat¡on:
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Total Fóes:
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OCC Group:tp{>Const. Type
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BUILDING / PLANNING DÍVISION :
Signed Approval Date