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HomeMy WebLinkAboutApplicationGurfteld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.Fa rfi eld-countv.com
BUITDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia ulti-Famil Demolition
Manufactured Home or Ti Home Si le or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwell Unit - MAXIMUM SIZE OF SQUARE FEET
INVOTVED PARTIES
Phone:
5
Property Own
Mailing Address
Email Address:
Phone 3o1- /S " lttContractor:
Mailing Address
Email Address:
v
Phone:(Architect:
Mailing Address
Email Address:
Phone: (_)Engineer:
Mailing Address
Email Address:
Phone: (Manufactured Home lnstaller:
Mailing Address
Email Address:
PROJECT DETAILS
Desqibe Work:
Height:
0
(ean
7
Lot
of Work:
Job Ad
Block
Assessor's Parcel Number:
Property Size (Sq. Ft. or Acres)
f of Floors
Sub.
Owner's Valuation
Sq. Ft. of Building:
AdditionClass of Work:New Remodel/Alteration
DetachedGarage:Attached
PROJECT DETAITS CONTINUED
Septic:f,WTS Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
pt Permit #
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
or an authorized agent. lt 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl"80days
of the date of issuance and if work is suspended 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 truc and corrcct. 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 L^,--L.. -,- r^ rl-^ 6..:l-l:,-- rl-^ .^."^.--.-t-. -l--^--:l-^-l -L-.,^ !L^.",^..1. II neterry Btdilr lrHrilrtrst(It tU r{lH n{iilritilB rIvr\t(l{r r(} eilrHt rilH I)I(rIiHrry, riHs(.irr)tsu d(i(rvE, r(, iilsllHl-r ilrH wrrN. r
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 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 understand the Notice and Certification above, as well as, have
the information which is correct and accurate to the best of my knowledge.
perty Owner Print and Date
OFFICIAT USE ONLY
Special Conditions:
Adjusted Valuation:Plan Check Fee:'"TtEi ..1>
Manu. Home Fee:Misc. Fees:
Total Fees\co is [65'ioo
Balance Due:BP No:6u-8so8 OWTS No:
Setbacks:OCC Group:ELE-Const, Tvoe:T.?T.'-$tf,'s.
BUILDING / PLANNING DIVISION
DateSigned Approval "..:r{-9c+