HomeMy WebLinkAboutApplicationGarfteld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82t2
www.garfi eld-countv.com
BUILDING PERMIT
APPLICATION
WPEOF CONSTRUCTION
Commercial/M ulti-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOIVED PARTIES
Phone:qPropefty Owner:
Mailing Address:
Email Address:
Contractor:Phone:?69-oolL
Mailing Address
Email Address:
3
Architect:Phone (
Mailing Address:
Email Address
Engineer: Phone:
Mailing Address:
Email Address:
Manufactured Home lnstaller Phon e:(
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:
Assessor's Parcel Number
Sub.Lot Block
Owner's Valuation of Work:Property Size (5q. Ft. or Acres):
Sq. Ft. of Building:Height:# of Floors: \
Class of Work:New Remodel/Alteration Addition
Garage Detached
Septic:f,WTS
PROJECT DETAILS CONTINUED
Community
Type of Heat:Natural Gas Electric OtherPropane
Aut[oritv. ThisapplicationforaBuildingPermitmustbesignedbvtheOwneroftheoropertv,describedabove,
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.
ng 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 suspended or abandoned for a period of 180 days after commencement.
Legal Access. A Buildi
pt
CERTIFICATION
Permit #:
NOTICE
Driveway
Permit:
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. I acknowledge that the Building
Permit ulay be suspended or revoked, upon nol"ice frorn the County, if the l<.rcation, constructiorl 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, ciiscovered 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 responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, 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 unde
provided the required information which is correctk-ar,,A,t--
rstand the Notice and Certification above, as well as, have
and accurate to the best of my knowledge.
7 Zrt
erop"rYyd*n"i print and sign Date
OFFICIAT USE ONLY CC
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee: _ -t'r31o .cre:.)
Manu. Home Fee:Misc. Fees:
Total Fees:OWTS No:
Setbacks
Balance Due:
Const. Type:
!-*
PaFees id od@
OCC Group:Zo tt :(r
a--lIdBUILDTNG / PLANNTNG DTVTStON
Signed Approval Date