HomeMy WebLinkAboutApplicationa a 6
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Development Department
8th Street, Suite 401
Glenwood Springs, CO 81601
(97Ols4s-8212
www.garfield-cou ntv.com
Property Owner:
Mailing Address:
EmailAddress:
Contractor:
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Phone
LLC phone:
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t 9701 97 r -'lo lo
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Mailing Address:
Email Address:
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Architect:
Mailing Address:
Email Address:
Engineer:h
Phone:o
Phone:7zo v - 73?t
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Mailing Address:
Email Address:Tih @ l-.rtt tnno-/.{znf<- tP Drrt
Gur.fiekl Couttty
BUILDING PERMIT
APPLICATION
D I erJ
Demolition
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Commercial/M ulti-Fami
nufactured Home or Ti Home or Mu
Residential or TownhomeDu
Accesso Dwelli Unit AD - MAXIMUM SIZE OF FEET
Manufactured Home lnstaller:Phone:
Mailing Address:
EmailAddress:
w rlt'bDescribe Work:
Job Address:
Assessor's Parcel Number
Sub.
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LR ,77
[ot Block
Owner's Valuation of Work: $
Sq. Ft. of Building:ttfilz
Class of Work:EW
Property size (5q. Ft. or Acres): 3? - t 6 AXtEt
# of Floors:-
Addition
Garage:Attached
ation l_l
t--l Detached
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Pernrit:
NOTICE
Autho. rlty. l lris applicatiotl l'or ir lluildirrg lrerrtrlt rrrust be' slgnetl lry the Owncr r:f tha propert y, tltl,r,ribatl ahovt:,
ot att itttthorircd agctrt. lf thc signalure brllow is noL that of the Owner, a sepfirate letter of authority, signtd by
thL. Owncr, nrust be provided with tlris Alrpllcation.
!gCALA!qq59. A Building Pent'rit carrrlot be lssutld wlthotrt proof of legal ancl arlequata acccss to the property for
purposes ol inspectiorrs by tlra Building Division.
other Permits. Multiplc separatc perrnits rrray be rcquircd: {1.) Stilte Electrlcal permlt, (2} County OW f5 Permit,
{3) another pernlit required for use on the property identifierl above, e.g. State or County Highway/ llrsiul Access
of a State Wastcwater Discharge pernrit.
ystd-tg$f& A Btiildirrg Pcrrtlt bccomes null and void if the work authorize d is not commenccd within 1ft0 rJays
of the date of issuancc arrd if work is suspended or abandoned for a periotl of 180 days after commencemcnt.
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CERTIFICATION
I hereby certify that I have read this Applicatlon 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
subrnitted by me or on rny behalf (submittals), based upon my certification as to accuracy, Assuming completeness
of the submittals and approval of tlris Application, a Building Permit will be issued granting permission to me, as
Owner, to construct the structure(s) and facilitlcs 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 requlring 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 hereby grant permission to the Building Division to enter the property, descrlbed 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, dlscovered after issuance; or (2) stopplng construction or use of the
structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other appllcable law. Review of this
Application, including submittals, and lnspections of the work by the Building Divislon 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 County Regulatlons rest with
me and my authorized agents, including wlthout llmitation my architect designer, engineer and/ or builder.
I hereby acknowledge that I have read Notice and Certlflcatlon above, as well as, have
provided is to the best of my knowledge.
K;rt lt- 04 2+
Property Owner Print and Slgn Date
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and
/HilbtSpecial Condltlons:5'F A
Mlsc. Fees:Manu. Home Fae:
N\ IA'ziill,"zsPlan Check Fee:
aB7, t+
OWTS t{or
I\l,As7ioullees:
728,
ailanie
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Fees Paltl'qlzA: \\
OCC Group:TQc-Setbacksr
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BUI[0|NG / P|ANNING olVlSlOH I
Slgned Approval Date