HomeMy WebLinkAboutApplicationGorfuld Coungr
Community Development Department
1OB 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.garfi eld-countv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Commercial/M u lti-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)T Reroof
Accessorv Dwelling Unit (ADU) - MAXIMUM SlzE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
Phone:?
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Email Address:
Contractor:79/F\Phone:
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Mailing Address:ao
Email
Architect:Phone:(
Mailing Address:
Email Address:
Engineer: Phone:
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone: ( )
Mailing Address
Email Address:
PROJECT DETAITS
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Describe Work:
rob Addres. BO
Assessor's Parcel Number:I
Sub.Lot 2 gtoct(
Owner's Valuation of Work:Property Size (Sq. Ft, or
Sq. Ft, of Building 15.5()Height:#of
u
Class of Work:New Remodel/Alteration Addition
Garage Attached Detached
l,
Type of Heat:
Septic:
OtherNatural Gas
Driveway
Permit:
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PROJECT DETAITS CONTINUED
Community
Propane Electric
Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
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. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
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
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 certificatioh as to accuracy. Assuming completeness
of the submittals and a pproval of this Application, a Building Permit will be issued granting permission to me, as
Uwner,to constructthe structure(s) and tacilities detailed on the submittals reviewed bythe 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, 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 herebygrarrt perrnission toihe Euiiciing Division to enterthe properiy, ciescribeci above, to inspecithe 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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
the required information which is correct and accurate to the best of my knowledge.
Property Owner Print and Date
OFFICIAT USE ONtY I
Special Conditions:
Adjusted Valuation Plan Check Fee:
\",M".bo Manu. Home Fee:Misc. Fees:
Total Feeslm oo Fees Paid:\ff) .oo
Bala Due:BP No:
",1-.F
€\eC OWTS No:
-$
lk
Setbacks:OCC Grouo:d(Const. Tvoe:flt zorrirui:{U
BUILDING / PLANNING DIVISION :
Signed Approval Date