HomeMy WebLinkAboutApplicationGarfteld County
Community Development Department
108 8th Street, Suite 401
! ; h,: , r, rii'Glenwood Springs, CO 81501
.r,-'ir\i\ : ." \t' pTOlg4S-92L2
www.garf ie I d-countv,com
Accessory Dwelli 1e unj! ({Q!l : MAIIM-U-IU sl,4-E oF ll00 squARE FEET
Engineer: Phone:
Mailing Address:
Email Address:
Manufactured Home Installer:Phone;{l
Mailing Address:
Email Address:
ts
Describe Work:
Job 6qq G
Assessor's Parcel Number:
Sub.Block _
Owner's Valuation of Work: $-Property Size {Sq. Ft. or Acres):
# of Floors
\r-
Lot
ew
BUILDING PERMIT
APPLICATION
I
Demolition
Reroofor Townhome)Residential {SF, Du
Manufactured Home (Single or Mu Iti-Level)
Architect:
cq - 265s
t./.
Y1(]
nu
c nl
Phoner c{ lo
Phone, fi"to t 471 - l6f I
Email Address:
Contractor:
Mailing Address
Email Addressr
Property Ownen
Mailing Address:
Mailing Address:
Email Address:
AdditionRemodel/AlterationClass of Work:
Garage:
Sq. Ft. of Building:
Attached
Height:
Detached
CommunitySeptlc:
OtherElectricNatural GasType of lleat:
Permit #:Driveway
Permitl
Propane
pt
PROJECT
Authoritv. This application for a Building Permit must be
or an authorized agent, lf the signature below is not that
Owner ofthe property, described above,
a separate letter of authority, signed by
signed by the
of the Owner,
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 Dlvision,
other permits. Multiple separate permits may be required: {1) State Electrlcal 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 Dlscharge Permit.
Void permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 daVs
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement'
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I hereby certify that I have read this Application and that th e 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 eompleteness
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)). All County development requiring a permit, except for
residential uses, are subject to Article 7 of the Land Use and Development Code. 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 compiiance with County Reguiation(s) or any other
applicable law.
I hereby grant permission to the Building Division to enterthe property, described above, to inspect the work. I
further aeknowledge that the issuance of the Building Permit does not prevent the Buildin6 Official from; (1) requiring
the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use ofthe
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 designer, engineer and/ or builder,
I hereby ackn that ! have read and understand the Notlce and Certificatlon above, as well.as, have
the information which is correct and accurate to the best of my knowledge.
.))5
rty Owner Print and Date
Cnarlal fanrlilianc.gFevrs,
I
Adjusted Valuation:Plan Check Fee:Fermlt Fee:
tC)rtr .cp Manu. Home Fee:Misc. Fees:
cpTotal Fees:\rn t55pc,Balance Due:BP No:
E8s?,\
OWTS No:
Setbacks:OCC GrouorT.tr0 Const. Tvoe:<'7I Zonlng:P
BUtLDtNG / PIANNtNG DtVtStON
Signed Approval
3')s'acl
Date