HomeMy WebLinkAboutApplicationGurfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970l.945-82L2
www.garfi eld-cou ntv.com
INVOTVED PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
Phone: q'zo t J.f{"Vd4
Email Addressl
Property Owner:
Mailing Address:
(
Phone: t?Va t ?tlf"rt? ?Contractor:
Mailing Address:
Email Address:
Phone: (_)Architect:
Mailing Address:
Email Address:
Phone: ( )Engineer:
Mailing Address:
Email Address:
Describe Work:
# of Floors:_Height:
Phone:
I
0
Property Size (Sq. Ft. or Acres), I, qAL
Lot _ Block
Email Address:
Sub.
Manufactured Home lnstaller:
Mailing Address:
Owner's Valuation of Work: S
Sq. Ft. of Building:
Assessor's Parcel Number
Job Address:
Remodel/Alteration AdditionClass of Work:New
Garage:Attached Detached
PROJECT DETAILS
PROJECT DETAILS CONTINUED
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required whieh is correct and aecurate to the best of my knowledgertr8 ",5 - goft I
Property Owner and Sign Date
Septic
Type of Heat:Otherral Gas Propane
Community
Electric
Authoritv. ThisapplicationforaBuildingPcrmitmustbcsigncdbythcOwneroftheproperty,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.
ding 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 L80 days after commencement.
Legal Access. A Buil
Permit #:
NOTICE
Driveway
Permit:
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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 notlce 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 herebygrant permission tothe Building Division to enterthe property, described above, to inspectthe work. 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 responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, I
acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with
ine arici rny auiirorizeci agents, irrciuclirrg witirout iirriiiatiorr my arcititect desigrrer, errgirteer andf or iluiicier.
CERTIFICATION
OFFICIAT USE ONLY
Special Conditionst
Adjusted Valuation Plan Check Fee:r Permit Fee: ^ ,-r,\n- ,Qr\-)
Manu, Home Fee:Misc. Fees
Total Fees:lcr'l.oo Fees Paid:loo,c,o Balance Due:ii#p-f;R#OWTS No:
Setbacks:OCC Group;<.0 n
Const. Type:
-no
Zofilg:\<
Q-<- -'tz j
() t) dY
Date
BUTLDTNG / PLANNTNG DTVTSTON
Signed Approva