HomeMy WebLinkAboutApplicationGarfreld County
$.{lili i, i cgmmunity Development Department
108 8th Street, Suite 401
APR {J I 2625elenwood springs' co 81501
tili{ i r'|: i ;': r'' ***.:'"#Li.tt"-:i,t"'.".-""
't .itli. :
TYPE OF CONSTRUCTION
BUILDING PERMIT
APPLICATION
DemolitionCommercial/M u lti-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
I Reroofex or TownhomeResidential (SF, Du
Dwell Unit - MAXIMUM SIZE OF SQUARE FEET
INVOTVED PARTIES
Q- ,n ,o . t/ito hl,grr€^ugt *honez(W I
Email Address:?,^ry'san D ia(. Care
lntBProperty Owner:
Mailing Address:
)Phone:(Contractor:
Mailing Address:
Email Address:
Mailing Address:
Email Addressi
Phone: (_)Architect:
Engineer:Phone: ( )
Mailing Address:
Email Address:
Pho ne: (Manufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECT DETAII.S
Describe Work:
Height:
of work: s 17. OoA
Sub.
Property Size (Sq. Ft. or Acres):
f of Floors
Assessor's Parcel Number
Job Address:
Lot Block
Owner's Valuation
5q. Ft. of Building:
Addition7t*"*Remodel/AlterationClass of Work:
DetachedGarageAttached
Septicr OWTS
Type of Heat ral Gas Propane Electric
Driveway
Permit:
Authority. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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 tsuilding Division.
Other Permits. Mriltiple 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.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days
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 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 regulatingthe work and the Garfield County Building Code, OWT\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.
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
acceptanceof responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, I
acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with
rne and my authorized agents, including without limitation my ai"chitect deslgnei", engineer and/ or buildei'.
PROJECT DETAITS CONTINUED
Community
Other
Permit #:
NOTICE
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
Q-a-.A 5?rlru n .il,atcs ,t/,/ns
Property Owner Print and Sign Date
OFFICIAI USE ONtY
Special Conditions:
Adjusted Valuation:
kl ,A
Plan Check Fee:
h\ ,tr ':JT&3:b*Manu, Home Fee:K\Itr Misc. Feesl
N] }A
TotalTees:
6rct"c*'+;lli;*Balance Due:
sar^,s
BP No: I
ferrr-9/?g
OWTfNo:
h. l/A
Setbacks:OCC Grouo:TtQ(-Const. Tvoe::trQ( -Zoning:
BUTtDTNG / PLANNTNG DtVtStON :
Signed Approval
Ile/es