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HomeMy WebLinkAboutApplicationGarfteld County Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 l970l e4s-8212 www.garfield-county.com BUILDING PERMIT APPLICATION CommerciaUMulti-Family Demolition Manufactured Home (single or Multi-Level)I lGas Piping I Residential (SF, Duplex or Townhome)Reroof Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,000 SQUARE FEET 618-9164 Email Address: Mailing Add ,...r, 188 County Road 259 Rifle, CO.81650 Property owner: Emily Kielmeyer Phone:970 1870 J 6/10 Road Fruita, CO. 81521 Phone:f 970 t773-O541Contractor:Genesis Plumbing & Hydronics Email Address:genesisphydro@outlook.com Mailing Address: PROIEETDETAIIS Describe Work:we need to run a L.P. steel gas line from entry into bu¡lding to a gas generator (provided by others). Total distance is less than 10' Job Address:188 County Road 259 Rifle, CO Assessor's Parcel Number: Sub.Lot Block Gas Pipe tength/ Diameter:314" dia. for less than 10' Appliances Serviced By Gas Line (list all, include BTU): furnace @ 155K btuh, Geneco*¡r à3¿ll¿ ðùu ã Class of Work:r'Alteration Type of Heat:I Gas r'Propane Addition NOTICE Authority. 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 property for purposes of inspections by the Building Division. Qlheflefm¡ts. Multiple separate permits may be required: (1) State Electrical Perm¡t, (2) County OWTS Permit, (3) another perm¡t required for use on the property identified above, e.g. State or County Highway/ Road Access or a State Wastewater Discharge Permit. VelC JeI¡U!.:\ 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 180 days after commencement. I hereby acknowledge that t 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. rìôJ¿ , ú"^r^ffi- ffi"r "-*r "¡"*nclicn Date 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, lagree 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 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 acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1) requiringthe correction of errors in the submittals, if any, discovered after issuance;or (2) stopping construction or use of the structure(s) or fac¡lity(¡es) 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 designer, engineer and/ or builder. çERTIFJCAÏON OFFICIAL USE ONIY Special Conditions: Adjusted Valuation: N/A Permit Fe\cr-)"oo Misc. Fees: '*(åä.oo '"iääiPo Balance Due: -æ BP No: W-Ltr.ß'A-\ \t""ff. BUTTDTNG / PLANNTNG DtvtstoN +å5e3 Signed Approval Date