HomeMy WebLinkAboutApplicationGarfteld Coanty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82t2
www.garfieldcountvco.gov
BUITDING PERMIT
APPLICAT!ON
TYPE OF CONSTRUCTION
Commercia ulti-Fami Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accesso Dwel Unit - MAXTMUM SIZE OF 1,200 E FEET
INVOTVED PARTIES
Property Ownen
Mailing Address:
Email Address:
Phone:pTDt q+8 lt5b
lat
A+talnlr_Le_
8t^!;
Architect:
Mailing Address:
Email Addressl
Phone:
Phone: ( )
Email Address:
Mailing Address:
Contractor:
Phone:Engineer:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone: (_)Manufactured Home lnstaller:
IINewRemodel/Alteration
PROJECT DETAITS
Describe Work
Lot
Height:Sq. Ft. of Building:5,uo0
er'sValuation of Work: S I?OOO Property Size (Sq. Ft. or Acres):
Assessor's Parcel Number
Job Address:
f of Floors:_
dition
BlockSub.
Own
Class of Work:
DetachedGarage:Attached
PROJECT DETAILS CONTINUED
Septic:Community
Type of Heat:Natural Gas Propane Other
Permit #
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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 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. Mu Itiple 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.
VoldPermlt. ABulldlngPermitbecomesnull 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 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, etote, or local law regulating thc work and the Garficld County Building Code, OWTS regulations and
applicable land use rbgulations (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
appiicable 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 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
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
required information which is correct and accurate to the best of my knowledge
4 eoK
Property Owner Print and Sign Date
Electric
Driveway
Permitr
OFFICIAT USE I
Special Conditions;
Adjusted Valuation:Plan Check Fee:Permit Fee:lrn oe Manu, Home Fee Misc, Fees:
Total Fees:\oo .oo 'r;1-Balance Due:
-1+
BP No:wnFqAffi OWTS No:
Setbacksr occ Const.zo4iqsl 1<vr*)
BUTLDtNG / PLANNTNG DTVTSTON :
Signed Approval
?:A6
Date