HomeMy WebLinkAboutApplicationGarfuld Coanty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-8212
www. garfi eld-cou ntv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Commercial/M ulti-Family Demolition
Manufactured Home or Ti Home Sin e or Multi-Level
Residential F Du ex or Townh I Reroof
Acces Dwelli Unit )- MAXTMUM S|ZE OF SqUARE FEET
tNVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone:r{?o I 6t6-0t16(
contractor:Phone:
Mailing Address:i\i t J 0n.-V.r',,. J Ar te
Email Address:t
Architect Phone: (_)
Mailing Address
Email Address:
Engineer: Phone: (-)-
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: (_)
Mailing Address:
Email Address:
Describe Work:tr-r coer €
Job Address:?C-IOO fAr*lu- 1' l>
Assessor's Parcel Number:
Sub.Lot Block
Owner's Valuation of Work:Property Slzb (S,q. Ft. or Acres):
Sq. Ft. of Building:t?E6 Height:# of Floors
Clast of Work:New RemodeilAltgration Addition
Garage Attached Detached
PROJECT DETAITS
PROJECT DETAILS CONTINUED
Community
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 strueture(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 ofthe
structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other
applicable law.
I horahrr crent narmiccinn fn +ha A"il,.li^d ni,;.i^^ +^ ^^+^-+h^ l^^^-iL^l ^L^.,^ +^ ;-^^^^+ +L^ ...^-1. Irw ErrLsr trrs PrvPcr !yr ucJLrlucu ouuvs/ LU ill>Pg9t !lrE wvrN. 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 suhmittals, if any, discovered after issr-rance; or (2) stopping construction or use of the
structure(s) or facility(ies) if such is in violation of CoLrnty RegLrlation(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. Asthe 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/ ot buildei'.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is and accurate to the best of my knowledge.
\-|t 'L''\
Property Print and Sign Date
Septic:
Type of Heat:
Driveway
Permit:
Propane Other
pt
Natural Gas Electric
Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
orartauthorizedagent. lftheslgnaturebelowisnotthatoftheOwner,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. ABuildingPermitbeconresnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
OFFICIAT USE ONtY \--/
Special Conditions:
Adjusted Valuation Plan Check Fee:'l",Tlf":bo Manu, Home Fee:Misc. Fees:
'TU6':""'OWTS No:
Setbacks:
Fees Paid:Balance Due:oo -e-
occ Const.tflnr
BUTLDTNG / PTANNtNG D|V|SION :
Signed Approval
LTAl
Date