HomeMy WebLinkAboutApplicationGarfuld CounS
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
www.ga rfi eld-county.co14
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Commercial/M ulti-Familv Demolition
Manufactured Home (Single or Multi-Level)I Gas Piping
Residential Du or Townhom Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES l7a pr I/L/€4 jtt-. - eU./rV{
Property Owner:
Mailing Address:
Email Address:
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Contractor:A)tssi.LLL phone:7
Mailing Address:
Email Address:
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Appliances Serviced By Gas Line (list all, include BTU):
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PROJECT DETAILS
Describe Work:
Assessor's Parcel N umber:
Job Address
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Alteration AdditionClass of Work:New
Natural Gas PropaneType of Heat:
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NOTICE
Authority. This aoplication for a Building Permit must be signed bv the Owner of the prooertv, described above,
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.
O_.lbCflermits. 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.
Vgidlglmj!..A Building Permit becomes null and void if the work authorized is not commenced within 180 days
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, lagreethat land 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)). 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 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 of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other
applicablc law. Rcvicw of this Application, including submittals, and inspections of the worl< by the Building
Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws
and County Regulations rest with me and mv authorized agents, including without limitation my architect
designer, engineer and/ or builder.
I hereby acknowl have read and understand the Notice and Certification above, as well as,
have provided information which is correct and accurate to the best my edge.
Sign DateP
OFFICIAT USE ONtY I
Special Conditions:
Adjusted Valuation
N/A
Permit Fegl. ^..\JL)\CC)
Misc. Fees:
Total Fees:\cn ,oo
Fees Paid:
(Cx'-)c,e)BAnce Due:
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Date
BUTLDTNG /PLANNING DIVISION :
Signed Approval