HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-82L2
www.Rarfi eld-cou ntv.com
WPE OF CONSTRUCTION
INVOTVED PARTIES
BUILDING PERMIT
APPLICATION
DemolitionCommercial/M ulti-Fami
T Reroof
e or Multi-Level
Residential SF, Duplex or Townhome)
Manufactured Home or TinY Home
Dwell - MAXIMUM SIZE OF 1,200 FEETUnitAccessoU
Email Address:
Phone:
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Property Owner:
Mailing Address:
Phone:
I
Contractor:
Mailing Address:
Email Address
Architect: Phone
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Phone: ()
Mailing Address:
Email Address:
)Phone:Manufactured Home lnstaller
t/o-t {
PROJECT DETAI[S
Describe Work
Height:
(€
('
Owner's Valuation of Work:
Sq. Ft. of Building:
Property Size (5q. Ft. or Acres):
Assessor's Parcel Number:
Job Addresst
Block _Sub. Lot
f of Floors:-
itionRemodel/AlterationNewClass of Work:
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Community
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.=-v!*-//4 €) 2 -""rL:- -> - +)
CWTSSeptic:
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
pt 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.
VoidPermit. ABuildingPermitbecomcsnull cndvoidifthcworkauthorizcdisnotcommcnccdwithinL80days
of the date of issuance and if work is suspended or abandoned for a period of L80 days after commencement.
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 Appllcation, 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) orany 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 ofthe
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 responsibilityorliabilitybytheCountyoferrors,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.
Property Owner Print and Sign Kt"
OFFICIAT USE ONtY
Special Conditions:
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Fees Paid:\oo oo Balance Due:a--BP No:FrF4lo?OWTS No:
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Signeci Approvai Date