HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
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Manufactured Home (Singte or Multi-Level)
Residential (SF, Duplex or Townhome)flneroot
Accessory Dwelling Unit (ADU) - MA)OMUM S|ZE OF 1,200 SQUARE FEEI y tr r * ^ t ern p ,
i INVOIVED.PARTIES
property osrn "r, K', , g * ?a-*v'\ <t a bo** o n phone: rql0l-.2J$-s3g 5-
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Malling Address:
Email Address:5V-;11 .L Ybe 1 9"7 (& art\a;1, (L:ryl
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Contractor:
Email Address:
Phone: I l
Malling Address:
Emall Address:
Archilect:LY +
Mailing Address:
Email Address:
Englneer:none -
Phone: rqlo)'z+ r t - zl I I(a
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Malllng Address;
Mailing Address:
Emall Address:
Manufastured Home lnstaller:Phoner I I
P*OJECTDETAILS
Descrlbe Work:
Job Addreg:1
Assesso/s Parcel Number:I
Sub.
Ownels Valuation of Work: $
5q. Ft. of Building:
Class of Work:
Gerege:
lot
e
Block
Property Sire lsq. Ft. or &resl! _
Helght;
BUILDING PERMIT
APPLICATION
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[(n
Remodel/Alteration
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Septls:
Type of Heat:
ncin€.
Gas Propane tlectric ,n*nuti.on€-
Oriveway
Lermr!:
N(yNCE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
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 Applacation.
Lelal Access. A Building Permit cannot be issued without proof ol legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Multiple saparate permits may be required: (ll 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 Wastetvater Dixharge Permit.
Void Permk. A Building Permit beconres null and void if the wort authorized is not commenced within 180 days
of the date of issuance and if work is zuspended or abandoned fior a period of 180 days after commencement.
CERNFrcAIOl{
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 lhe Application, along with the plans and specilications and other data
submitted by me or on my behall (submittals), based upon my certilication 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 reniewed 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 lncal law regulating the work and the Garlield County Building Code, OWfi 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(sl and facility{ies}, described above, are not in compliance with County Regulation(s} or any other
.^^ti^-ht^ t-,r,sPPilLou,s roYr.
I hereby grant permission to the Building Division to enter the property, described above, lo inspect the work. I
further acknowledge thal the issuance of the Building Permit does not prevent the Building Official from: (1) requiring
the correction of errors in the subrniltalt if any, discovered after issuance; or (2) sfopping construction or use of the
structure(s) or facility{ies} il such is in violation of County Regularion{s} or any other applicable law. Review ol this
Application, including submittals, and inspections of the worl by the Building Division do not constitute an
acceptance of responsibility or liability by the County ol errors, omissions or discrepancies, As the Owner, I
acknowledge that responsibility for compliance with lederaf 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 tha llotice and C;ertification aboye, as well as, have
provided the required information *?hich as correct and accurate to the best ol my knowledge.
[o"'* 4ee le*te- ff^ite,
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Propefty Owner Print ard liigrr Date
oFFlctAt usE oiltY I
Special Conditions:
^8,Tif':8'Plan Chedr Fee;
9u.5 r
Permit Fec:
r 31.25
Manu- Horne fee:Misc. Fees:
Total Fees:
?Zq, ru 6'3lat .Balance llue:
h tCC ,55
BP ?IO:Wr-Qra"OWISNo:
Setbacks:OCC Group:Const. Type:tpu'
V-ts-zsBUIIDTNG / PtANNlt{G DtVtStOr:
DateApproYal