HomeMy WebLinkAboutApplicationGarfield CoanQr
Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(s7ol94s-82L2
www.garfi eld-countv.com
OF
BUILDING PERMIT
APPLICATION
DemolitionCommercia
Manufactured Home or Tiny Home (single or Multi-Level)
I ReroofResidential (SF, Duplex orTownhome)
-l Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
PARTIES
Property Owner:
Mailing Address:
Email Addressl
sqP-1 q22*6t?L
4I
Phone:
w\e
u_-
"_
\h PhoneContractor:
Mailing Address
Email Address:
Architect: Phone:
Mailing Address:
Email Address:
Phone: ( )Engineer:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone:(Manufactured Home lnstaller:
PROJECT DETAITS
Job Address:
Describe Work:
Lot
Owner's Valuation of Work:
BlockSub.
Property Size (Sq. Ft. or Acres):
# of Floors:
Assessor's Parcel Number
Sq. Ft. of Building: Height:
itionRemodel/AlterationClass of Work:New
DetachedAttachedGarage:
PROJECT DETAILS CONTINUED
Community
Propane Other
Driveway
Permit:
NOTICE
Authorltv. Tlris appllcatlon for a Bulldlng Permlt musr be slgned by the Owner of rhe properry, descrlbed above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Leeal 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. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true and correct. I
undei'stai-rd thai tiie Buiicjir-rg Divisiori accepts tiie Appiicaiion, aiong with the pians and specifications and other ciata
submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness
of the submittals and approvalof 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, 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 lssuance of the Building Permrt does not prevent the Burldrng Uffrcral from: (1) requrrrng
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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the ired information which is correct and accurate to the best of my knowledge,
? -a .z--<-
Pro Print and Sign Date
Permit #:
]WTSSeptic:
Type of Heat:I Gas Electric
\otOFFICIAT USE ONLY
Special Conditions:
Adjusted Valuation Plan Check Fee:Fee:ooPermit\oo Manu. Home Fee:Misc. Fees:
Total FeesI ^^ t-lla)
[ (r-, .--Fees Paid:
t a\/\ tn^)\\.rr\-/ . \4./
Balance Due:
v-BP No:6---.- n r -^K.r)OI- --\\(J-\
OWTS No:
Setbacks:OCC Group:air -
Const. Tvoe:uT-$ifls
BUTLDTNG / PLANNTNG
Signed Approval
3- 3as
Date