HomeMy WebLinkAboutApplicationDocuSign Envelope lD: 471 1 D31 5-C949-483E-8567-D4DA2B08CF2E
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l e4s-82t2
www.garfiel ntv.com
Garfuld County
BUILDING PERMIT
APPLICATION
DemolitionCom mercial/M ulti-Family
T Gas PipingManufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
618-9164Phone:
188 Co Rd 259, Rifle, CO 81650, USA
970Propertyowner: Emily and Justin Kielmeyer
Email Address:elm6@msn.com
Mailing Address:
237-3800
Email Address:hayley @ socosolarpower.com
Mailing Address 37227 112Rd Grand Junction CO,81501
Contractor:SOCO Solar& Power Phone: t970 )
10 feetGas Pipe Length/ Diameter:
Appliances Serviced By Gas [ine (list all, include BTU):
Lot Block
Describe Work:Generator Gas inspection, Gas line is outisde
Job Address:188 Co Rd 259, Rifle CO 81650
18kw ge nerac standby qenerator
Assessor's Parcel Number:
Sub.
Alteration AdditionClass of Work:r'New
Natural Gas PropaneType of Heat:
DocuSign Envelope lD: 471 '1 D31 5-C949-483E-8567-D4DA2B08CF2E
NOTICE
Authority. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, rnust 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.
Qlhgffgfmits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Perrnit,
(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.
V_Srdle114t=1\ 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 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 eounty, if the location, construction or use
of thestructure(s) and facility(ies), described above, are not in compliancewith 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)
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. 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 acknowledge that I have read and understand the Notice and Certification above, as well as,
have p htd information which is correct and accurate to the best of my knowledge.
4/8/2024
Property Owner Print and Sign Date
OFFICIAT USE ONtY
5pecial Conditions:
\
Adjusted Valuation:
N/A
Permit Fee: rl;l,nt /f)urr.--Misc. Fees
Total Fees:tww Fees Paid:
\oo.co
Balance Due:*g BP No:-mA-gt&Zoning
R
q4-94BUILDING / PLANNING DIVISION
Signed Approval Date