HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
l970l94s-8212
www.garfield countvco.gov
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Mu Demolition
Manufactured Home or Tiny Home (single or Multi-Level)
Residential (SF, Duplex orTownhome)I Reroof
Accessory Dwell Unit - MAXTMUM S|ZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone: t.bK )Q9c" 2926
Phone:1Qyo1 ia5^ fqETContractor:
Mailing Address:
Email Address:
PhoneArchitect:
Mailing Address:
Email Address:
Phone: ( )Engineer:
Mailing Address
Email Address:
Phone
Email Address:
Manufactured Home lnstaller:
Mailing Address
PROJECT DETAILS
Describe Workl
Height:
Iot
of Work:
Sub.
Property Size (Sq. Ft. or Acreslr
# of Floors:_
Assessor's Parcel Number:
Job Address:
Block _
Owner's Valuation
Sq. Ft. of Building:
flaooitionClass of Work:New Remodel/Alteration
Attached DetachedGarage:
PROJECT DETAITS CONTINUED
Septic:Community
Type of Heat:
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 rne or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness
ofthequbmittalsandannroval ofthiqAnnlicatinn aRrrildinoPprmitwill hpicsrpdsrAnlinsnermissinntomp as
Owner, to construct the structure(s) and facilities detailed on the submittals reviewed bythe 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 herebygrant permission tothe Building Division to enterthe property, described above, to inspectthe 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
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 which is correct and accurate to the best of my knowledge.
o?- )5-25
Property Owner Print and Sign Date
Propane E lectric
Driveway
Permit:
Other
Permit #
Natural Gas
Exempt
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 Permitcannot be issued without proof of legal and adequate accesstothe propertyfor
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 ldentified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Fermit.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
OFFICIAT USE ONIY
Special Conditions:
Adjusted Valuation:Plan Check Fee:i"iry5*bo Manu. Home Fee:Misc. Fees:
Total Fees\oo.€)Fees Paid:[oo .oe)
Balance Due:t BP No:6F.q\rco OWTS No:
Setbacks:'Hfl,D
-:B]23-BUILDING / PLANNING DIVISION
Signed Approval Date