HomeMy WebLinkAboutApplicationGarfuld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.ga rfi eld-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 Rer:oof
AccessorV Dwellins Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
I Phone:3 ?
L)\e- C
Email Address:
Contractor:Phone: JZo I
Mailing Address
Email Address:
Architect:Phone:
Mailing Address
Email Address:
Engineer:Phone
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone:(
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:d
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:# of Floors
Class of Work:New Remodel/Alteration Addition
Garage:ArbTKd Detached
PROJECT DETAITS CONTINUED
Septicl
Natural Gas Propane
Corrrrnurrity
E lectric OtherType of Heat:
Driveway
Permit:
Exempt 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.
VoidPermlt. ABuildingPermitbecomesnull andvoldlftheworkauthorlzedlsnotcommencedwlthln1SOdays
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 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 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, 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 hereby grant permission to the Building Division to enter the property, described above, to inspect the 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 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 responsibilityorliabilitybytheCountyof errors,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.
{*- Ti=-*'6- q- zq
Property Owner Print and Sign Date
OFFICIAL USE ONLY
Special Conditions:
Adiusted Valuation Plan Check Fee Permit Fee: '.-tt ,-tt ^
( ,/l ,/
I ( /( ,/ .-
Manu. Home Fee:Misc. Fees
Total Fees:(){ )I
Fees Paid: ^.zrt n^ (*/
/( "t( L
Balance Due:BP No:",--*1- (fuz'\<(A) t' -6Ey
OWTS No:
Setbacks:OCC Group Const. Type:'ul'-
BUTLDTNG / PLANNTNG DTVTSTON
Signed Approval Date