HomeMy WebLinkAboutApplicationGarfteld
Qpnrnun iW DeveloPme nt DePa
' '' " *lUFSh street, suite 401
11Ur, Fler]ly,ppd Springs, co 81601
?\ '- '"""19701945-8212
l'.t:l':t':=L@uuii,r,.i lll{i t? offfiEruf
Dwelli Unit (ADU - MAXTMUM SIZE OF 1,200 SqUARE FEET
Phone:
Phone:
G
'^//
Phone: (
7Property Owner:
Mailing Address:
EmailAddress:
Contractor:
Mailing Address:
Email Address:
Architect:
Mailing Address:
Email Address:
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Demolition
Home (Single or Multi-
mercial/Multi-Family -
Manufactured Home or Ti
ReroofResidentialor TownhDu
INVOLVED PARTIES
Engineer:
Mailing Address a
Email Address:
Manufactured Home lnstaller:Phone
Mailing Address
Email Address:
PROJECT DETAILS
Describe Work:
b/{ -
Job Address:
Assessor's Parcel Number
Phone: \a; ^1 ?:;T- a ')
II
e
,l; . 'i
.t
Sub.
,i
Owner's \tali.ration of Work:
Sq. Ft. of Building:
New
Size (Sq. Ft. or Acres): 7.7/f
# of Floors: A? /
Addition
Garage:Attached
Height:// f+
Detached
Type of Heat:
Driveway
Permit:
Septic:
Natural Gas Propane
PROJECT DETAITS CONTINUED
Community
Electric Other
Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Applieation.
leeal 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.
Void Permit. 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, I agree that I and my agents will comply with provisions of any
federal, state or local law regulating the work and th€ 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 eompliance with County Regulation(s) or any other
applicable law.
I hereby grant permission to the Building Division to enter the propertv, described above. to inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (L) 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
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 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 i and accurate to the best of my knowledge.
Property Owner Print and Date
OFFICIAT USE ONIY
Snpcial fnnr{iiinnc'
bAdiusted Valuation:
$46212.4
Plan Check Fee:$zn1'Permit Fee:
{.rtr.75
Manu. Home Fee:Misc. Fees:
Total Fees:
-l*.^q Y'y'-+b tB J t7b
FeffR{* t1 ct.c t .Bjltl.," D,lS'-
$.il,it \_,.'JCr
BP No:A . ^ ^-. a.V*I'I).6YNb
OWTS No:
Setbacks:OCC Group:Const. Type:ton'u L
I -c.z a. _ vtBUTTDtNG / PTANNING DtVtStON :
proval Date