HomeMy WebLinkAboutApplicationGarfield County
Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.garfieldcountvco.gov
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Comme Iti-Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Du or Townho I Reroof
Dwelli Unit DU - MAXTMUM S|ZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
I
Phone: (WO I zEfr {A73Property Owner:
Mailing Address:
Email Address:
I
$24 I (O
&P^2_o
contractor: A lun b.-r.W phone:(qzot GtS,bGf+
Mailing Address:Po Bcr< zz"3 <; (E CA AlG{z
Email Address:a, ( n n ab ^c a-v\ r|-6 o C',t q, Q'h t lr*."' 1, c u "-.
Architect:Phoner ( )
Mailing Address
Email Address:
Engineer:Phone:
Mailing Add
Email Address:
Manufactured Home lnstaller:Phone:
Mailing Address
Email Addressl
PROJECT DETAILS
Describe rA^f"-f ,*s{'J( G' Lo- tar<I*,-
o"lOV2-{"rv
Job Address:O Vlea"t f.
Assessor's Parcel Number:
Sub.Lot Block _
Owner's Valuation of Work:Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:# of Floors:
/'t 30N
Class of Work:New /Remodel/Alteration Addition
Garage:
;OAttached
Detached
PROJECT DETAITS CONTINU ED
Authorltv. 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 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.
Vold Permit. A Building Permit becomes null and void if the work authorized is not commenced within J.80 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 lcw rcgulating the work ond thc Gorficld County Building Codc, OWTS rcgulations 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
appiicabie iaw.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the 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
acceptanceof responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, 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
provided the required information which is correct and accurate to the best of my knowledge.
{
Property er Print and Sign Date
Septic:
Type of Heat:Natural Gas Propane
Driveway
Pcrmiti
Exempt
Community
OtherElectric
Permit #:
NOTICE
OFFICIAT USE ONtY
Special Conditions:
Adjusted Valuation Plan Check Fee:Permit Fee:
\or-r ,o Q)
Manu. Home Fee:Misc. Feesl
Total Feesltoo ,Qa)
Fees Paid:
tcro oo Balance Due:--o-BP No:wr rlFcl OWTS No:
Setbacks:OCC Grouo:'-f)f,( -"ot:tfr'si:i
BUTLDTNG / PIANNING DTVTSTON
Signed Approval Date