HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
(970194s-8212
www. garfield-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF 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
INVOTVED PARTIES
Property Owner:
Mailing Address:
Phone:
Email Address:
Contractor:Phone
Mailing Address
Email Address:
Lnd
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: S Property Size (5q. Ft. or Acres):
Sq. Ft. of Building:Height:f of Floors:_
Class of Work:New Remodel/Alteration n
Garage:Attached etached
I
Septic:fWTS
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permitl
Exempt Permit #
NOTICE
PROJECT DETAI[S CONTINUED
Community
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,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.
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 suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
lherebycertifythatlhavcrcadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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, lagreethat land myagentswillcomplywith 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, ifthe location, construction or use ofthe
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^ h.,:li:.-- rl-- -..^.-1, Ir ilcrcuy grdilL perrilr5sruil LU Ure Duilurilc urv15ruil LU enLer L{te Prr)f)ett)/, rre5(_||(Jeu dr)uve; tu Ir5PeLL Lile wurK. r
further acknowledge that the issuance of the Building Permit does not prevent the Building Officialfrom: (1) requiring
the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use ofthe
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 agenis, 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
provided the required information which is correct and accurate to the best of my knowledge.
d ."-h/-4s,r -J- /W-"t"-<'1 -\-t*L-\.-7\a
Property Owner Print and Sign Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:Loo , crQ)Manu, Home Fee:Misc. Fees
Total Fees
\co co Fees Paid:\oo C.)c,
Balance Due:+-fuil'Y-q(\3 OWTS No:
Setbacks:OCC Group:-T-0 0
Const. Tvoe:lOrt Zonine:?trN
a'ab')tBUILDTNG / PLANNTNG DTVTSTON
DateSigned Approval