HomeMy WebLinkAboutApplicationGarjield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701s4s-82t2
www.garfieldcou ntyco.gov
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Fami Demolition
Manufactured Home or Tiny Home (S le or Multi-
IResidentialFDuplex or Townhom Reroof
Accessory Dwelling Unit - MAXIMUM SIZE OF 1,200 SQUARE FEETADU
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
1'8Phone:
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Phone:
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Mailing Address:
Email Address:
Contractor:
Phone: (Architect:
Mailing Address:
Email Address:
Engineer: phone: (_)
Mailing Address
Email Address:
Phone: (_)Manufactured Home lnstaller:
Mailing Address
Email Address:
PROJECT DETAII"S
Describe Work:
{)v-+
of
Lot _ Block _
Owner's Valuation of Work:
Sub.
Assessor's Parcel Number
Property Size (Sq. Ft. or Acres):
# of Floors:Sq. Ft. of Building; Height
Job Address: 6
Class of Work:New Remodel/Alteration Addition
Garage Attached Detached
PROJECT DETAI LS CONTINU ED
Septic:Community
Type of Heat:Natural Gas Propane E I ectri c Other
Driveway
Permit:
Exempt Permit #:
NOTICE
r a Building Permit must be signed by the owner of the 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.
Itiple separate permits may be required: (1) state Electrical permit, (2) coun
e property identified above, e.g. State or County Highway/ Road Access
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 1g0 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Other Permits. Mu ty OWTS Permit,
Authority. This application fo
(3) another permit required for use on th
or a State Wastewater Discharge Permit.
CERTIFICATION
is 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. In
consideration of the issuance of the Building Permit, lagree that land 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 Countydevelopment requiringa permit, exceptfor
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.
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
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 certify that I have read th
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 knowle dge
Property Owner Print and Sign Date
OFFICIAT USE ONtY
Special Conditions
Adjusted Valuation:Plan Check Fee:Permit Fee.oo Manu. Home Fee:Misc. Fees:
Total Fees:oa Fees Paid
OO
Balance Due:BP
\
OWTS No:
Setbacks:OCC Group tng:
BUTLDING / PLANNTNG DtVtStON :
Signed Approval
5-1,lS
Date