HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(s7ol94s-82t2
www.Fa rfi eld-cou ntv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Commercial/Multi-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
propertyowner: lu,ftYLLrt/ WWt? Phone: qT) ) L'2<"-74LI\
MailingAddress: L'lO )z Leti*-w \Ztl tl,fl '3ct1
, i:lwtt'' Ctlorni , 'r, <?tL'1.f
Email Address
Contractorl Phone:0
Mailing Address
Email Address:
J
Architect:Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone: ( )
Mailing Address:
Email Address
Manufactured Home lnstaller:Phone: (_)
Mailing Address:
Email Address:
Describe Work:o - tZe iZoof
Job Address:t'77r An 3a9 Pt"r,. /- l? -/-f 1- F( 6:'s'-
Assessor's Parcel Number:
Sub.Lot Block
owner's Valuation of work: S 3 4 aaO Property Size (Sq. Ft' or Acres):
Sq. Ft. of Building:Height:# of Floors:_
Class of Work:New Remodel/Alteration Addition
Garage:Attached Detached
PROJECT DETAILS
PROJECT DETAII.S CONTINU ED
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.
llr-.r^.4 t'trl
Property Owner Print and Sign Date
Type of Heat:
Septic:
Natural Gas Propane
L_lowrs Community
E lectric Other
Driveway
Permit:
Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
ing Permit cannot be issued without proof of legal and adequate access to the property for
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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.
Legal Access. A Build
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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, lagreethat land myagentswill complywith 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 law.
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 submittais, if any, discovered after issuance; or (2) stopping construciion or use ofihe
structure(s) or facility(ies) if such is in violaticn 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
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 Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
CERTIFICATION
OFFICIAT USE ONtY
Special Conditions:
Adjusted Valuation Plan Check Fee:iFti"":cP Manu. Home Fee Misc. Fees:
'TUU aa Fees Paid:\co oo BaraS BP No:rp.b38 OWTS No:
Setbacks:OCC Groun:+Q!-Const. Typei<,00-zoros,
\a-aa-a
Date
BUILDING / PLANNING DIVISION
Signed Approval