HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.ga rfi eld-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com ta Iti-Fam Demolition
ufactured Home or Ti Home or Multi-Level
-nesidential (SF, Duplex or Townhome)I Reroof
Accessory Dwelli Unit DU . MAXIMUM SIZE OF SQUARE FEET
INVOI.VED PARTIES
Phone: (t?a) 3\1 - f6q<Property Owner:
Mailing Address
Email Address:
Pho ne:Contractor:
Mailing Address:
Email Address:
Phone:Architect:
Mailing Address:
Email Address:
Phone: (_)Engineer:
Mailing Address
Email Address:
Phone:
Email Address
Manufactured Home lnstaller
Mailing Address
PROJECT DETAITS
Describe Work:
Height:
Lot
Property Size (Sq. Ft. or Acres):r{C)
Block _
Assessor's Parcel ber:
Sub.
f of Floors:
Owner's Valuation of Work: S
Sq. Ft. of Building:
Job
ditionRemodel/AlterationClass of Work:New
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwnerofthepropertv,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.
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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is sr-rspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
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)). All County development requiring a permit, except for
residential uses, are subject to Article 7 of the Land Use and Development Code. t acknowledge that the Building
Permit may be suspended or revoked, upon notice fronr 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.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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
acceptanceof responsibilityorliabilitybytheCountyof errors,omissions,ordiscrepancies. AstheOwner, I
acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with
me and rry authorized agents, including withouL lirril.aLiorr rrry architect desigrrer, errgirreer and/ or builder.
I hereby acknowledge that I have and understand the Notice and Certification above, as well as, have
provided on ich and accurate to the best of my knowledge.
o b/,t /r,l
and oate /
Septic:
Type of Heat:
Driveway
Permit:
Natural Gas Propane Other
Community
Permit #:
E lectric
NOTICE
OFFICIAL USE ONIY
5pecial Conditions:
Adjusted Valuation Plan Check Fee Permit Fee:Manu. Home Fee:Misc. Fees:
Total Fees Fees Paid:Balance Due:BP No:OWTS No:
Setbacks:OCC Group Const. Type:Zoning:
BUTLDTNG / PLANNING D|V|SION :
Signed Approval Date