HomeMy WebLinkAboutApplicationGarfuld Countyilii i n't
-Comr4unity Development Department
I . , 198 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94S-82L2
www.Fa rfi eld-cou ntv.com
PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com ulti-Famil Demolition
Manufactured Home or Ti Home or Multi-Level
Residential (SF, Duplex or Townhome)Reroof
Dwelli Unit DU)- MAXTMUM SIZE OF SqUARE FEET
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Email Address:
Property Owner:
Mailing Address:
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Contractor:
Mailing Address
Email Address:
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Architect:
Mailing Address:
Email Address:
Phone:hnttt{-LL10
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Engineer: Phone:
Mailing Address:
Email Address:
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Manufactured Home lnstaller: Phone:)
Mailing Address
Email Address:
PROJECT DETAILS
k *,"1L I,.fSDescribe Work:
Job Address:
# of Floors:_
I L €
Height:
Assessor's Parcel Number:
J6Lot
I t/,A 3 oG Vooo 44
Block
Ft.orAcres): ), 4!7 a'deProperty Size (Sq.
Sq. Ft. of Building:
Owner's Valuation of Work: $
Sub.
Remodel/Alteration AdditionClass of Work:New
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Septicl ]WTS Community
Type of Heat:atural Gas Propane Electric Other
Driveway
Permitl
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.
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 submittalsand approval of thisApplication, 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 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
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 a that I have read and understand the Notice and Certification above, as well as, have
provided n which is correct and accurate to the best of my knowledge.
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Property r Print and Sign oat{ I
OFFICIAL USE ONtY
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Adiusted Valuation:
['54 7e .6d
.Plan Check Fee
fr-8 r.4 I
Permit Fee:
t25.Z5
Manu. Home Fee:Misc. Fees:
{'2["t'rc fees Paid:?a.3\Balance Due:(34.sJ BP No:
Pr--8$-qRD,^
OWTS No:
Setbacks:occ GrouP: t(g-Const. Type:zonip
to-1-4BUILDING / PLANNING DIVISION
Date