HomeMy WebLinkAboutApplicationGarfuld County
R E C E$g[![1unity Development Department
t08 8th Street, Suite 401
JUh! U ni lfipfenwood Springs, co 81601
G A R F
l E,L P . :: t :i,*;.(-?,?1"?oo-t i,1?.."'
cOMl.1lit'llTY ni\/sl-. -;- "
BUILDING PERMIT
APPTICATION
TYPE OF CONSTRUCTION
Commercial/M ulti-Fami I Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Dwel Unit - MAXTMUM S|ZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
l.Phone: totlo f ?tq {Eoo
EmairAddress: SKt*rf*S USf dgSQ Gr r4lt- (orrt
Contractor:Phone: ( )
Mailing Address:
Email Address:
Architect:Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone: ( )
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.Lot Block
Owner's Valuation of Work:(Property Size (Sq. Ft. or Acres):4f
Sq. Ft. of Building:t4o'(Height:f of Floors: I
Class of Work:New Remodel/Alteration I laoaition
Garager Attached LJ Detached
PROJECT DETAITS CONTINUED
Septic:CWTS Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
Permit #
NOTICE
AuthoriW. This application for a Building Permit must 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 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.
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,
Vqldlennj!. A 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.
CERTIFICATION
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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)). 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 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 acknowiecige that the issuance of the Buiiciing Permit cioes not prevent the Buiiciing Officiai from: (i) 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 here that I have read and understand the Notice and Certification above, as well as, have
required information which is correct and accurate to the best of my knowledge.
( -c.t4|w\tul
Owner Print and Sign Date
OFFICIAL USE ONIY I
speciaf conditions: tl"uA 1-ldl*to Be-7tr o.t GgJfi€LD <rl,r./'C1 ul?L65
A Puyu^.(- r5 tsSrrex->
Adiusted Valuation:Plan Check Fee:Permit Fee:Manu. Home Fee:Misc. Fees:
Total Fees:""i8"*Balance Due:BP No:
N€rn€ -t{+ls
OWTS No:
Sctbacks:OCC Groupr Const. Typer 'u:\
6*7 -24BUILDING / PTANNING DIVISION
Date