HomeMy WebLinkAboutApplicationGarfield Coanty
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www. garfi el d-cou ntv.com
WPE OF CONSTRUCTION
Commercial/Multi-Fa mily
Manufactured Home (Single or Multi-Level)
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Demolition
Residential
Accessory Dwell Un
Þ1 Qvplç¡or Townhome)itllR;¡;ói
slzE oF 1,000 SQUARE FEET
BUILDING PERMIT
APPLICATION
; INVOTVED PARTIES
Property Owner
Mailing Address
Email Address:
Contractor:
Mailing Address
Email Address:
Architect:
Phone: 4+o)17t-q1fl,
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Phone: ( )
Mailing Addressr
Email Address:
Engineer:Phone:
Mailíng Address
Email Address:
Manufactured Home lnstallen Phone:
Mailing Address
Emaíl Address¡
pnóieci DcrÁns
Describe Work:
Job Address
Assessor's Parcel Number:lôt hc
Sub Lot Block
Owner's Valuation of Work:,0D Property Size (Sq. Ft. or Acres):
5q. Ft. of Building:Height f of Floors
Class of Work:New Addition
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Garage Attached
Remodel/Alteration
Detached
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Septic:
Type of Heat:Natural Gas Propane
Community
E lectric Ol"her
Driveway xempt Permit #:
Permit:
r NOTICE
Authoritv. TÈiiapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with tlris Applicatiorr.
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" Murltiple 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
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Void Perrnit. 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 period of 1"80 days after commencement.
i 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 acccpts 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 Buildirrg Pernrit will be issued granting
permission to me, as Owner, to construct the structr¡re(s) and facilities detailed on the sr¡bmittals reviewecl þy
the Building Division. ln consideration of the issuance of the Building Permit, I agree that land my agents will
comply with provisions of atry federal, state or loc¿l l¿w regulaLirrg Llre wurk antl Llte Gar[ield Courrly 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, 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 Building Permit does not prevent the Building Official from: (1)
rcquiring thc corrcction of crrors in thc submittals, if any, discovered after issuance; or (2) stoppirrg
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
Divlsion 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
deslgne¡,eer and/ 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.
Pro er Print and Sign
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Date
oFFrcrAL usE oNry PAID t lo0 .ôó (.c. otl lzl l¿o?iz &tu
Special Conditions:
Adjusted Valuatíon Plan Check Fee Permit Fee:*lo o.oo
Manu. Home Fee:
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Misc. Fees:
Total Feesl Fees Paid:
$loo. oo
Balance Duetø BP Nor
R.o oF,? T?8
OWTS No:
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Setbacks;OCC Group Const. Type:l. R.c.
Zoning:
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Date
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