HomeMy WebLinkAboutApplicationGarfield County
FU\LÞINC'
Community Development Department
1Og 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.garfield-coqntv.com
TYPE OF CONSTRUCTION
com ry9-¡ci a!1!!q[¡i-Fam i ly
Manufactured Home (Single or Multi-Level)
Resid entia I (SF, Du PlqI "9-rJ9-ryü9 rnel
AccessoryÐwqlllg udt (ADU)- M¡xlMUM slZE OF SQUARE FEET
PARTIES 7K l.Êt qîa --+*4r'524"
properry owner: WfiÊl&üA ea*Oon¡$nSVt &thone: ( 4?a l nLE' :342t
Mailing Address:C. Q..
Email Address:c2r v e?t-¿o @ cro\ . cola\
I
BUILDING PERMIT
APPLICATION
Contractor:14ú LL_Í À.ir QøoÉC-lâ
Mailing Address¡
Phone:q (t ã-f
Email Address:an¿)Ax 55.. Øþa
Architect:r-[ - a.Phone:
Mailing Addr€ssi ,
Email Address: - -
)Engineer:9C-t4.C*¡oJ¡ Fa.pË.J ø .ç Phone:ñflo fi49'rooL
Mailing Address:TB awø c.o E
EmailAddress: ,, ,
Manufactured Home Installer:il.A Phone :l
Mailing Address: . ,, -
EmailAddress:
PROJECT DETAII.S
Desribe Work:
Job Address:tttor L-ø_ ftt?-
Assessor's Parcel Number:
Sub. Lot Block-
Property Size (Sq. Ft. or Acres):
ition
Owner's Valuation of Work:
Sq. Ft. of Building:
Class of Work:
C^-^-^.
New
¡f r+..ho'{iE ln Remodel/Alteration
#of
flpt¡rhed
2v
PROIECT DETAILS GONTINUED
Septic:Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
?ermit:
NOTICE
Permit #:
-
nuthority. ihis applicatiàn tor 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.
Lesal 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 perm¡ts. Multiple separate permits may be required: (L) 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 authorízed 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
t neieOy cert¡fy that I have read this Application and that the information contäined above is true and correct' I
understand that the Building Division accepts the Application, along w¡th the plans and specifications and other
data submitted by me or on my behalf (submittals), based upon my certification as to accurãcy. 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 Build¡ng 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 locat¡on, construction or use
of the structure(s) and facility{ies), described above, are not in compliance with County Regulation(s) or any
other appl¡cable 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
dgsiSner, engineer andl or builder'
I hereby acknowledge that I havê read and understand the Not¡ce ana ıártirication above, as well as, have
provided the required which is correct and accurate to the best of my knowledge.
-Þræ,Fæ-v42 -21
Property Owner Print Sign Date
7e%zl
cK-rrtl¡t3OFFICIALUSE ONIY 20¿|,3.
LSpecial Conditions:
/
Manu. Home Fee:¡t/r Misc. Fees:'wi:*gsPlan Check Fee:213.70Adiusted Valuation:it oÐo
BP{o:
BLCO ' G?t O
Balance Due:4st.ASFees Paid:
s ?ql. ?'eíotål rees:Q!¡\'IS No:
^t /A
Zoning
c L
const. Type:#'8'öïR.2Setbacks:
BUILDING / PLANNING DIVISION :
Date