HomeMy WebLinkAboutApplicationGarfuld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.garfield-countv.com
BUILDING PERMIî
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)T Reroof V
Accessorv Dwelline Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOIVED PARTIES
Property Owner:
Mailing Address:
Email Address:
,î(" r tv\¿PhoneLf,r"êÆt
Phone:Contractor:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
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Architect:Phone:
ìPhone:(
Mailing Address:
Email Address:
Engineer:
Phone:Manufactured Home Installer
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:
t'
Iot
Height:
Owner's Valuation of Work:(
BlockSub.
Property Size (Sq. Ft. or Acres):
f of Floors:_Sq. Ft. of Building:
Assessor's Parcel Number:
Job Address:
New Remodel/Alteration AdditionClass of Work:
DetachedGarage:Attached
ll'Septic:
PROJECT DETAITS CONTINUED
Community
Type of Heat:Otheratural Gas Propane Electric
Driveway
Permit:
Permit #:
NOTICE
Authoritv. This application for a Buildi¡tg Perrnit rnust be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provlded 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
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 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 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 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 issuancc of thc Building Pcrmit docs not prcvent thc 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. AstheOwner, lacknowledgethatresponsibilityforcompliancewithfederal,stateandlocal laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
designer, engineer and/ or builder.
I hereby acknowledge that I have and understand the Notice and Certification above, as well as, have
provided the requi red and accurate to the best of my knowledge.
Property er Print Sign Date
OOOFFICIAT USE ONtY I
Special Conditions:
ndjusted Valuation:Pian Check Fee:'iä:i"."öo Manu. Home Fee:Misc. Fees:
croTotal Fees:Ioo Fees Paid:
\ cJô.oo
Balance Due BP No:
æ -8rq<
OWTS No:
Setbacks:OCC Group:Const. Type:Zpqi4g:
PL1 T\
BU!LDING / PLANNING DIVISION
Signed Approval
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Date