HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970ls4s-82t2
www.garfieldcountvco.Sov
BUILDING PERMIT
APPUCATION
WPE OF CONSTRUCTION
Com mercial/M ulti-Fami Demolition
Home (Si e or Multi-LevelManufactured Home or Ti
Residential Du or Town Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SlzE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Email Address:
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Property Owner:
Mailing Address:
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Phone:
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Phone: t 4zq 6ta'ttf"S-'7contractor:
Mailing Address
Email Address:
Architect:
Mailing Address:
EmailAd
Phone: ( )Engineer:
Mailing Address:
Email Address:
PhoneManufactured Home lnstaller:
Mailing Address
Email Address:
PROJECT DETAITS
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of work: 5 7z-(ft/72 Property size (Sq. Ft. or Acres):
i6u/ft
B 4at a
3
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Block
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# of Floors:_
Remodel/Alteration
Assessor's Parcel Number:
Describe Work:
lzJob Address:
Height:
Owner's Valuation
5q. Ft. of Building:
Sub. lot
7CI Y-
7 DetachedAttachedGarage:
PROJECT DETAITS CONT!NUED
Property Print and Sign
I
Septic:Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit;
pt
NOTICE
AuthoriW. This application for a Building Pei'mit must be signed by the Owner of tlie property, described above,
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.
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
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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, lagreethat land myagentswill complywith 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 acknowledgc 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
appircable iaw.
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 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
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 Notiee and Certification above, as well as, have
provided the req uired information which is correct and accurate to the best of my knowledge.
Permit #:
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Date
oFFrcrAr usE oNrY:!I
Special Conditi0ns
Adjusted Valuation:Plan Check Fee:\ffi""'oo Manu. Home Fee:Misc. Fees:
aoTotal Fees
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Fees Paid:OO\nn.Ba lance Due
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BP No:(T^,..r raArrlY{ l( I ts--1,-rl lq
OWTS No:
Setbacks:OCC Grouo:-rPr Jt U'F,"-'"#ry'
Signed Approval
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Date
BUTLDTNG / PLANNtNG DtVtStON