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Home My WebLink AboutApplicationGarfield CountY i{I t'li':inI , rrrr .; ,, Qg-tpmunity Development Department .i, " 'i 1\r' tO8 8th Street, Suite 401 ; l,,,,i:iir p7}lg45_g?.l2 www.garfi eld-countv'com BUILDING PERMIT APPLICATION DemolitionWPE OF CONSTRUCTION Commercial/Multi-Famil IManufactured Home or Multi-Level tn Reroof Gas Residential F, Duplex or Townhome UnitDwelli D FEETSQUAREFoMUMAXIL,2OOstzEM INVOIVED PARTIES AI;. l- (23 C)\Phone IL l-,4 -r... Email Address Property Owner: Mailing Address: Mailing Address: Email Address: Phone: (-)-6.*.Contractor:t{rt-o",r*r/Fe r-re-\ PROJECT DETAILS Describe Work: Job Address:) Assessor's Parcel N umber:ztL ZS zooo i.1 1':5 Lot - Block -Gas Pipe Length/ Diameter:zs" 3/-(" Appliances serviced By Gas Line (list all, include arul' '-l-ufrutrt< , 4S'00D KTO fKRtte"tionNew AdditionClass of Work: Propaneatural GasType of Heat: Atrthnritw Thic rnnlinr+inn fa, - D,.irr:^rrrrJ ovvrrLdLrurr rur d trullolng i'ermlt n-ril5t be st8ned bythe Owner of the property, 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 forpurposes of inspections by the Building Division. Other Permitc I\rrrllinl6 c6h-.-+^ A^!6;+^ -^.- L^ .--- !v!!!L!LL!!!!!rr' rvrurLiPrs:eirdrdLepermlrsmaytrerequlred: (1) StateElectricai Permit,(Z) CountyOWTSpermit,(3) another permit required for use on the property identified above, e.g. state or county Highway/ Road Accessor a State Wastewater Discharge permit. NOTICE VgjlLPcIIUlrA Building Permit becomes null and void if of the date of issuance and if work is suspended or aban the work authorized is not commenced within 1g0 days doned for a period of 180 days after commencement. TION I hereby certify that r have read this Application and that the information co ntained above is true and correct. Iunderstand that the Building Division accepts the Application, along with the plans and specifications and otherdata submitted by me or on my behalf (submitt als), based upon my certification as to accuracy. Assumin ccompleteness of the submittals and approval of this Application, a Building permit will be issued gra nti ngpermission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed bythe Building Division. ln consideration of the issuance of the Building permit, I agree that I and my agents willcomply with provisions of any federal, state or local law regulating the work and the Garfield County Build ingCode, OWTS regulations and applicable land use regulations (County Regulation(s)). I acknowledge that t heBuilding Permit may be suspended or revo ked, upon notice from the County, if the location, construction or useof the structure(s) and facility(ies), descri bed above, are not in compliance with County Regulation(s) or anyother applicable law I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. Ifurther 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) stoppingconstruction or use of the structure(s) or facility(ies) if such is in violation of county Regulation(s) or any otherapplicable law' Review of this Application, including submittals, and inspections of the work by the BuildingDivision do not constitute an acceptance of resoonsibilitv or liahilitv hrr rhp cnrrn+r t nr orra"" nmicai^^- ^-discrepancies. As the owner, I acknowredge tt'at ,esponriLli,;l;;:;;;i,1.."*'i;' i"J"ij]'*i;il rJ.rr rr*,and Cottntv Reprrlatinnc racf rrri+h ma rn,.l ,-., -,.+L^-:-^r'!Lb!r'uL'v"r ' s)L wrtrr Irrc drru my aurnorlzed ageilis, including without limitation my architectdesigner, engineer and/ or builder. I hereby acknowledge that r have read and understand the Notice and Certification above, as well as, to the best of my knowledge. la -7u1-7t-1 have provided the required i is correct and accurate Property Owner Print and Sign Date c[. OFFICIAL USE ONLY I I Special Condltionsr Adjusted Valuation:rvll5c. Fees: Fees \ Balance Due: €-ng: Total Fees oo BUTLDTNG / PIANNtNG Dt Signed Approval Date loee/