HomeMy WebLinkAboutApplicationGarfield County
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(97O)e4s-82t2
www. garfi eld-countv.com
OF CONSTRUCTION
Commercial/Mult¡-Fami
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Residential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU). MAXIMUM SIZE OF 1,OOO SQUARE FEET
INVOTVED PARTIES
Demolition
Reroof
Property Owner:
Mailing Address:
Ëmail Address:
Contractor
Mailíng Address:
Email Address
Architect:
Phone: (+þ)7*0 17t?
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Phonel
Maíling Address
Email Address:
BUILDING PERMIT
APPLICATION
Engineer Phone: ( )
Mailíng Address
Email Address:
Manufactured Home lnstaller:Phone: (_)
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:
Job Address
Assessor's Parcel Number:2 o ù o?¡å
Sub.4 Lot Block
Owner's Valuation of Work: S &Ð,y Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:îm Height:# of Floors:_
Class of Work:New ition
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Garage Attached
Remodel/Alteration
Detached
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PRoJEcr oriars coñnñueo
Septic:Community
Type of Heat Natural Gas Propane Electric
Permit #:
Otlrer
Driveway
Permit:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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 properiy for
purposes of inspections by the Building Division.
Other Permits. Mult¡ple separate perm¡ts 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
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Void Permit. A Building Permit becomes null and void if the worl< 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 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 thc 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 Buildirrg
Code, OWTS regulations and applicable land use regulations (County Regulation(s)). lacknowledge 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.
lherebygranIperttrissionl.otheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. I
further acknowledge that the issuance ot the Building Permit does not prevent the Building Official from: {L)
requiring the corrcction of crrors in thc submittals, if any, discovcrcd 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
9.uli€nç1, glgi neer or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
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Prope Owner Print and Sign Date
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Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
*loo.oo
Manu. Home Fee
N/^
Misc. Fees:
Total Fees Fees Paid:
$ loo.oo
Balance Due:+ø BP No:
R,oo F -7417
OWTS No:
-¡/rSetbacks:OCC Group:Const. Type:
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Zoning:
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Date
BUILDING / PTANNING DIVISION :
Signed