HomeMy WebLinkAboutApplicationCoun
Commu nity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www.ga rfieldcou ntyco.gov
BUILDING PERMIT
APPLICATION
DemolitionCommerclal/Multi-Famlly
Manufactured Home or Tiny Home {single or Multi-Level)
I ReroofResldential (SF, Duplex or Townhome)
Dwell Unit - MAXIMUM SIZE OF FEET
Property Owner:
Mailing Address:
Email Addressr
Phone:
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Phone: t'fio t ut\b*912LContractor:
Malllng Address:
Email Address:
Architectl Phone: { }
Mailing Address:
Emall Address:
Malllng Address:
Phoner ( )Engineer:
Email Address:
Sub. Lot--
owner's Valuation of workr S { €j , gg C')
Sq. Ft, of Buildlng: Height:
-
# of Floors:-
Descrlbe Work:
Phoner ( )Manufactured Home lnstaller:
Propertv Size (Sq, Ft. or Acres):
Assessor's Parcel Number:
Job Address:
Block
Mailing Address:
Email Address:
RemodeUAlteration AdditionClass of Worl<:N"ry.^.,
ii-^L^r
q
Garagel Detached
Septlc:]WTS Community
Type of Heat:Gas
_lPropane
Electric Other
Drlveway
Permltr
t
l*lExemp
Permit #:
Authoritv, This application for a Building Perrnit 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 provlded with this Application.
Lesal Access. A Buildine 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: (l-) State Electrical Permit, {2) County OWTS Permit,
(3) another permit required for use on the property identified abovq e.g. State or County Highway/ Road Access
or a State Wastewater Dlscharge Permit,
Vold Permlt. A Buildi ng Permit becomes null and void if the work authorized is not commenced within 3.80 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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 submlttals and approval of this Application, a Building Permit will be lssued granting permission to rne, 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 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
resldential uses, are subject to Article 7 of the Land Use and Development Code, I acknowledge that the Building
Permlt 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
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I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I
further acknowledge that the lssuance of the Bulldlng Permlt does not prevent the Buildin6 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) lf 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 no| constitute an
acceptance of responsibility or liability by the County of errcrs, omissions, or discrepancies, As the Owner, I
acknowledge that responsibillty for compllance wlth Jederal, state and local laws and County Regulations rest with
me and my authorized agents, including without lirnitation.my architect designer, engineer and/ or builder,
I hereby acknowledge that I have read and understand the Notlce and Certlllcatlon above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign Date
Special Conditions:
AUJUste(r vdlualr(Jn;rtan LnecK ree;Per^mit Feel\mr.c2c)fuianu. Home Fee:Mlse. Fees:
Total Fees:
\ oo. c)e/Fees Paid:too.w Balance Due:+*BP No:
?.octF 9.IR+
OWTS No:
Setbacks;':"':'1?v{-*,s'i'h-4
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Date
BUrrDrNc / PLANNtNG DtVtStON
Signed Approval
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