HomeMy WebLinkAboutVOID-ApplicationGarfuld County
BUILDING PERMIT
APPLICATION
RE Development Department
108 8th Stree! Suite 401
Glenwood Springs, CO 81601
i.;j\; r: ii: I i-r {;f.;i It'J"i-(970) 945-8212
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TYPE OF CONSTRUCTION
Commercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
\ccessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOIVED PARTIES
Property Owner:
Mailing Address:
Email Address:
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Phone:I
Phone:Contractor:
Mailing Address:
Email Address:
Phone:Architect:
Mailing Address:
Email Address:
6
tEngineer:
Mailing Address:
Email Address:
Phone:Manufactured
Email
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PROJECT
Describe
- loO
rctSq. Ft. of Building: _
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T
Iot
Height:
Property Size (Sq. Ft. or Acres):zo.6zo *
Block _
Owner's Valuation of Work:25,a@
#of
Job Address:
Assessor's Parcel Number:
Sub.
Remodel/Alteration AdditionClass of Work:New
Garage:Attached Detached
PROJECT DETAIUT GONTINUEO
Septic:Community
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the which is and accurate to the my
Property and Sign Date
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Type of Heat:Gas Propane Electric
]ottrer
Drbanray
Permit:lExempt Permit #:
Authoritv.This appl ication for a Building Permit must be signed by the Owner of the property,described a bove,
or an authorized agent.rf the signature below ts n ot that of the Owner,separate letter of authority signed by
the Owner,must be provided with this Application
Lesal Ascess. 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 Permlts. Multiple separate permits may be required: (1) State Electrical permit, (2) County OWTS permif
(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.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 1g0 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTlFrcAflON
I hereby certifi/ 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 permlt, 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 count% if the location, consiruction 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)
requiring the correction of errors in the submittals, if any, discovered afrler issuance; or (21 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 errort 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
or builder.
USE ONLY \
Special Conditions:seaafu&//
Adjusted Valuation:'5Xr:',JT Permit Fee:Manu. Home Fee:Mlsc. Fees:
Total Fees:Fees Paid:
0%u.\ \Balance Due:BP No:
w 0-E3ll.3
OWTS No;
Setbacks:OCC Group:Const, Type:
,
BUTTD|NG / PTANN|NG DtVtSlOr{
Slgned Approval Date