HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPLICATION
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82t2
www.Fa rfi eld-countv.com
TYPE OF CONSTRUCTION
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1"1 iltF :.itit,i
C..c! ill
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q-f,DemolitionCom mercial/M ulti-Fami ly
Manufactured Home or Tiny Home (Single or Multi -Level)
ReroofResidential (SF, Duplex or Townhome)
Dwellin Unit DU - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
t-k-M S Phone:fil7)619.>tolP
(t\,/P"^
ro l-t€-rs A^'qrO "\4/\
Contractor:Su,v.*gr- &S aj.o"rZ Phone:I )
Mailing Address
Email Address:
Architect: A,{Phone:e
Mailing Address:
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O I 5 o,l
LOvutEmail Addressr
Engineer:sna vuufiton",
Mailing Address:
Email Address:
vno/-;an Co 5 0.1
O"C4--(a-crtl {-{-. Cav-<
Manufactured Home lnstaller:Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAITS
u-$.t""w LA'o r,^
Job Address:I v\,,t c a,D,r.l \^-(-
Assessor's Parcel Number:o o5 o
Sub.\ri\t0 Block
Owner's Valuation
Sq. Ft. of Building:
of Work:Property Size (Sq. Ft. or Acres):5 8 ,Ac"eS
oo Height:# of Floors:_
Class of Work:New y Remodel/Alteration
-
Addition
Garage:Attached Detached
PROJECT DETAITS CONTINUED
Community
Electric Other"
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 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.
VoidPerrnit. ABuildirigPerrrriLbecurnesnull arrrlvuidil[]reworkauthorizedisnotcorrtrnencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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.
=4-
Property Owner Print Sign
./l-,
Date
Septic:
Type of Heat:ral Gas
Driveway
Permit:
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 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, ifthe location, construction or use ofthe
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 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.
OFFICIAT USE ONtY I
Speclal Condltlons:
Adjusieci Vaiuation:Pian €heck Fee:
---*
Permit Fee:too .oc,
Manu. Home Fee:Misc, Fees:
Total Feest.n.oo ooFees Paid:tnn.Balance Due fftqo.ss OWTS No:
Setbacks:OCC Group:Const. Type:ffi5
z.Lt-25BUTLDTNG / PIANNtNG DtVtStON :
Signed Approval Date