HomeMy WebLinkAboutApplicationGarfteld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www. ga rfi eld-cou ntv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Demolition
Manufactured Home or Ti Home or Multi-
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwelli Unit DU - MAXIMUM SIZE OF 1,200 SqUARE FEET
INVOTVED PARTIES
Phone:(,oProperty Owner:
Mailing Address:
Email Address:
c,
trtq (s78
l,'nile'x b,tol)Oet l -(a>yr.
Contractor:r" 6 m tToo frrt I Phone: t2ZOl 6 Lo
Mailing Address
oEmail Address:
Architect:Phone: (
Mailing Address:
Email Address:
Engineer:Phone: (_)
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: t )
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work f e. - loo$
robAddress:7 66 t'rt+, t hctdou-< f l'f tlel 6ien trrood <P^i 25 <
Assessor's Parcel Number
Sub.
Own
Lt'e<+er h t+ ill: rct 3 etock 4
er's Valuation of Workl Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:#of
Class of Work:New Remodel/Alteration Addition
Garage:Attached Detached
/g16e(
PROJECT DETAITS CONTINUED
Septic:OWTS Community
E lectric Other
Darmir I+.
Type of Heat:atural Gas Propane
Drirrawev
Permit:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,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. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
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, lagreethat land myagents will complywith 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 h^"^h', dr.h+ ^^16i..i^h +^ +h^ D',ildi^^ ni.,i-i^h +L^ --^^^-+,, t^-^.iL^l ^h^.,^ +^ i^-^^^+ +f,^,^,^-1. Irrrsrsuy6rqrrr|JEr LULrrsuuilurr16urvrJrvrr(vsrrLcr LrrcPrvPcrtyruEJurrusuduuvsr(uil|JPELLLrrcvvurN. 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 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 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
provided the required information which is correct and accurate to the best of my knowledge.
/X C-atlo! (x,nzakZ rnqt/c'zon
Property Owner Print and Sign Date
8* , -'?o.Zt 1
OFFICIAL USE ONTY
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee: ^.locl .cu
Manu, Home Fee:Misc. Fees:
'ffi'%o Balance Due:J+-'Q*.',.,F-BlsT,
OWTS No:
Setbacks
Total Fees:do\ oc>
OCC Group:TLO Const. Tvoe:ai14 t"["f^
.
BUTLDTNG / PLANNTNG DtVtStON
Signed Approval Date
7 - 7ot