HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
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www.garfieldcou ntvco. gov
TYPE OF CONSTRUCTION
INVOTVED PARTIES
BUILDING PERMIT
APPLICATION
DemolitionCommercial/M u lti-Family
Manufactured Home or Tiny Home (Single or Multi -Level)
I ReroofResidential (SF, Duplex or Townhome)
Dwelling Unit DU - MAXIMUM SIZE OF 1,200 SQUARE FEET
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Email Address:
Property Owner:
Mailing Address:
2
Phone: fl% I 3 5< ^ o-t ?7Contractor:
Mailing Address
Email Address:
Architect: - Phone: (-)-
Mailing Address:
Email Address:
Engineen Phone:
Mailing Address: _
Email Address:
(
Manufactured Home lnstaller: Phone:
Mailing Address:
Email Address:
PROJECT DETAITS
Sub, Lot
-
Block
Describe Work:
Height:f of Floors
of Work:Property Size (Sq. Ft. or Acres)
Assessor's Parcel Number:
Job Address:
Owner's Valuation
Sq. Ft. of Building:
Remodel/Alteration AdditionClass of Work:New
DetachedAttachedGarage:
PROJECT DETAILS CONTINUED
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
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. 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
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 Pcrmit will bc issucd granting pcrmission to mc, 05
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 willcomply 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
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lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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 n which is correct and accurate to the best of my knowledge.
03- 2r-'L4
Property Owner Print and Date
SWTS
Type of Heat:
Septic:
Natural Gas Propane Electric Other
Community
Driveway
Permit:
Exempt Permit #:
OFFICIAT USE ONtY
Special Conditions:
Adjusted Valuation:Plan Check Fee:i"#i"Po Manu. Home Fee:Misc. Fees:
Total Fees:
\ oo 9ro 'r".ri'ho Balance Due:e*BP Norr)u.qlsq OWTS No:
Setbacks:OCC Grouo:fl]-Const, Tvoe:aQ-| -
t"fr'
BUTLDtNG / PLANNTNG DIV|SION
Signed Approval Date