HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s82'f'2
www.garf ield-county.com
BUILDING PERMIT
APPLICATION
DemolitionCommercial/M ulti-Family
I Gas PipinsManufactured Home (Slngle or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
SQUARE FEET- MAXIMUM SIZE OFUnitDwe
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Email Address:
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Email Address:
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Gas Pipe tength/ Diameter:
Appllances Servlced By Gas $ne (list all, Include BTU):
Describe Work:
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l4Assessoy's Parcel Number:
Job Address:
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NOT!EE
Authority. This application for a Building Permit must be signed by the Owner of the property, described abovc,
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 of inspections by the Building Division.
Qlhglefmits. 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.
V-sldlelnd!.A Building Pcrmit becomes null end void if the work authorized is not commenced within 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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 orr tlre subrnittals 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)). 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, described 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, 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
n:.,:-:^^ l^ ^^+ ^^^^+:+ ^^^ ^t -^^^^-^:L:l:!,. ^- !:^L:l:r.. L., !L^ i^..-t., ^I ^--^-- ^-^:^-:^-- --urvr>turl uu rrvl lurr5rr(urq drr duuEPtdilLg vt tc)P9il)tuiltty ut ildulilty uy ttte LUuilLy ut gttut>, ulill55tuil5 uI
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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as,
have provided thgrelwedyfgation which is correct and accurate to the best ofrmy knowledge.
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erop"rty O*i"?Print and -. v it'5r8n Date
Special Conditions:
Adjusted Valuation:
N/A
Permit Fee: ^l111l).c)g
Misc. Fees:
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Fees Paid:
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Zoning:
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BUILDING / PLANNING
Signed Approval
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Date