HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-8212
www.garfi eld-countv.com
WPE OF CONSTRUCTION
Commercial ulti-Fami;ly
Manufactured Home or Home e or Multi-Level)
INVOLVED PARTIES
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BUITDING PERMIT
APPLICATION
I Demolition
ReroofResidential (5F, Duplex or Townhome)
Accesso Dwelling Unit U - MAXIMUM SIZE OF SQUARE FEET
Property Owner:
Mailing Address:
Email Address:
Phone:
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Email Address:
contractor: SIl,t,lH.*.r,rnlr.ril
Architect: t l A Phone:
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Mailing Address
Email Address:
t/ L Phone: t )Engineer:
Mailing Address:
Email Address:
Phoner
PROJECT DETAILS
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# of Floors;,,(4.^' vz {lvztn c*.1- Icl"kHeight:
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Sq. Ft. of Building:3frQ r IuFt
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Manufactured Home lnstaller:
Describe Work:
Owner's Valuation of Work: 5 Property Size (Sq. Ft. or Acres):
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Mailing Address:
Email Address:
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Lot -----.--Btoslc--
Assessor's Parcel Number
Sub.
Job Address: {7 Ll Lo'
Class of Work:New Remodel/Alteration dition
Garage hed Detached
PROJECT DETAITS CONTINUED
Septic:Community
Type of Heat:Natural Gas Propane E lectric Other
Driveway
Permit:
Exempt
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access. ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
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.
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 an d 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 constructthe 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 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, 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 Iaw.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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 responsibilityorliabilitybytheCountyof errors,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.
Permit #:
NOTICE
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print -.-n5rgn
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Date
OFFICIAL USE ONtY
Special Conditions:
Manu. Home Fee:Misc. FeesPlan Check Fee:'Iki:a"Adjusted Valuation
OWTS No:
fb"lro-qmt-5.E.oo oo.QS
Fees Paid Bilbnce Due:+
'"ru(OCC Group:Const. Type:Setbacks:
il-4-4BUILDING / PLANNING DIVISION :
Approval Date