HomeMy WebLinkAboutApplicationGarfield Coanty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(e7ol94s-8212
www.garfi eld-countv.com
BUILDING PERMIT
APPLICATION
DemolitionCom mercial/M u lti-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
I ReroofResidential (SF, Duplex orTownhome)
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
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Email Address
Property Owner:
Mailing Address:
F Lun CoC Phone:fQa'OfLl
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Contractor:
Mailing Address:
Email Address:
Phone: (q+O I 36CnlS
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Phone:(Architect:
Mailing Address:
Email Address:
Ensineer: Phone:
Mailing Address:
Email Address:
Describe Work:
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Job Address
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Phonel (
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Manufactured Home lnstaller:
Mailing Address:
Email Address:
Sub. Lot
Owner's Valuation of Work: S
Height:
Block
Assessor's Parcel Number:
Property Size (5q. Ft. or Acres):
f of Floors:Sq. Ft. of Building:
AdditionClass of Work:New Remodel/Alteration
DetachedGarageAttached
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PROJECT DETAITS CONTINUED
Septic:)WTS Community
Type of Heat:atural Gas Propane
Driveway
Permit:
OtherE lectric
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 cf 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
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 the Garfield County Building Code, OWTS regulations and
applicable land use regulations (County Regulation(s)). All Countv 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 compliance with County Regulation(s) or any other
applicable law.
I herebygrant permission tothe Building Division to enterthe property, described above, to inspectthe work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Officialfrom: (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 acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the red which is correct and accurate to the best of my knowledge.
tlrl tiIL ^.\ ri, i,U L"I
r Prini anri Sion Deto
OFFICIAT USE ONIY
Special Conditions:
Adjusted Valuation:Plan Check Fee:iZH'"6o Manu. Home Fee:Misc. Fees:
'iHITib ooFees Paid:\oo.Balance Due:
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BP No:ffiF-8mA OWTS No:
Setbacks OCC Group Const. Type:'tt'
BUTLDTNG / PLANNTNG DtVtStON :/Haa_?
DateSigned Approval