HomeMy WebLinkAboutApplicationGarfuld CoanSt
, :.. Fpmmunity Development Department' 108 8th Street, Suite 401
.:r i. .r i'i rr'.,$lenwood Springs, CO 81601,! r ' i! .',,. pTOlg S_g2Lz
www.ea rfi eld-cou ntv.com
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BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
DemolitionCommercialIti-
I
Reroof
Gas nManufactured Home (Sin e or Multi-Level)
Residential (sF lex or Townhome)
Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEETDwell
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
qa R 4F Snea tc\<Phone 37 - 322V
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Contractor:g1p rv >lL Phone: (3J9 37 9'3 z z 3
Mailing Address:
Email Address:
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PROJECT DETAILS
Describe Work:zlaosF Goa 642 A'>7rc '<--
AdditionAlterationClass of Work:
PropaneftfruaturatcasType of Heat:
Job Address:
Assessor's Pa
zgTD Cr< /D?-s co
rcel Number:
Sub rct 45 ewct<
Gas Pipe Length/ Diameter:5 -pt
Appliances Serviced By Gas Line (list all, include BTU):Quout-*rz (L
NOTICE
Authority. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,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.
Legal Access. A Buildirrg Perntit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
O:lhef-Pe-Lmits. Multiple separate permits may be required: (1) State Electrical Perrnit, (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.
Vgtdleqnj!.A Buildirrg Perrrtit beconres null arrd void if the work authorized is not commenced wlthin 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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)). 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
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 Countv Regulations rest with me and my authorized agents, inclr-rding without limitation m!/ a!"chitect
designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as,
have provided uired information which is correct and accurate to the best of my knowledge.
V u z 7
Property and Sign Date
USE ONLY
Special Conditions:
Adjusted Valuation
N/A
Permit Fellartnnw Misc. Fees
Total Fees Fees Paid Due:Bala ZonCD@
a
BUTLDtNG / PLANNTNG DtVtStON
Signed Approval Date