HomeMy WebLinkAboutApplicationGarfreld CountY
Community Development Department
108 8th Street, Suite 401
Glenwood SPrings, CO 81601
19701945-82t2
www.garfleld-countv.com
Dwelli Unit (ADU - MAXIMUM S¡ZE OF 1,üro SQUARE FEFT
Property Owner:
Mailing Address:
Email Address;
Phone:
Malling Add
Emall Address:
Arch¡tect:Phone:
Mailing Address:
Email Address:
Engineer;Phone :f
Mailing Addre¡s:
Email Address:
Manufactured Home lnstaller:Phone:
Mailing Address
Email Address:
Describe Work:
Job Address:5 cÊ c ?l
Assessor's Parcel Number:2113 3 L't oo aêl
5ub.Block
-
Owne/s Valuation of Work: S- Property Size (Sq. Ft. or Acres): 2 ' 3 l8
'
Sq. Ft. of Building: Height: ü of Floors:-
Class of Work:New ¡t¡on
Iot
BUILDING PERMIT
APPLICATION
i.
Demolition
¡Reroof
CommerciallMulti-FamilY
gle or M
ex orResidentialD
Manufactured Home
Garage:Attached
RemodeUAlteration
Detached
CommunltyCWTSSeptlc:
OtherElectricPropaneNatural 6as
Permlt #:
Type of Heat:
Drlveway
Permlt:
AuthoriW. Thi s application for a Building Permit must be signed by the Owner ofthe property, described above,
or an authorized agent. lf the signature below ¡s not that of the owner, a separate letter of authority, signed bY
the Owner, must be provided with this Application.
leqal 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. Mu¡t¡ple sepãrate perm¡ts may be required: (1) State Electrical Permit, (2) County OWTS Permit,
t¡l rnotft"r permit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Permit.
Vold 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 períod of 180 days after commencement.
I hereby certify thet I have read this Application and thet the information
understand that the Building Division accepts the Application, along with
contained above istrue and correct. I
the plans and specifications and other
data submitted by me or on my behalf (submittals), based upon my certífication as to accuracy, Assuming
completeness of the submittals and approval of this Application, a Building Perm¡t 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 Build¡ng 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 not¡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 aiknowledge that the issuance of the Building Perm¡t does not prevent the Build¡ng official from: (1)
reouiring the correct¡on of errors in the submittals, if any, discovered after issuance; or (2) stopping
.oirtrri-t¡on or use of the structure{s) or facility(iesl if such is in violation of County Regulatlon(s) or any other
applicable law. Review of this Application, including submittals, and inspections of the work by the Building
Division do not const¡tute 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 w¡th me and my authorized agents, including without limitation my architect
or builder
thet I have read and understand the Notice and Certlfication above, as well as, have
provided the requlred information which ls correct and ascurate to the best of my knowledge.
Property Owner Print and Sign
Special Condltlons:
Mlsc. Fees:Manu. Home Fee
ì!./A
Permit Fee:Plan Check Fee:Adlusted Valuation:
OWTS No:
¡l/s
BP No:
R.oo F'?a{ 2-
Balance Due:+y'Fees Pald;*þo 9o
Total Fees:
ätôo.to
Zonlng:ç,utALOCC Groupl
C-
Setbacks:
N /*
BUil"DtNG / PTANNING DlVlSlON ;
Dâte
oslt I/zt
Const. Type:lßs