HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
l970ls4s-82t2
www.ga rfieldcountvco. gov
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/M u lti-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Dwelli Unit (ADU - MAXTMUM S|ZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
O,J S Phone:j
I
Email Address:
Contractor:Phone: 8"7o I Ltt'l o "OA i9
7-,t
Mailing Address:
Email Address:
Architect:Phone
Mailing Address
Email Address:
Engineer: Phone:I )
Mailing Address:
Email Address
Manufactured Home lnstaller:Phoner ( )
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub. Lot
-
Block
Owner's Valuation of Work:Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:f of Floorsl_
Class of Work:New Remodel/Alteration Addition
Garage:Attached Detached
i
i
PROJECT DETAITS CONTINUED
Septic:Community
Type of Fleat:Natural Gas r I vpor rE EI^^+-i^LtcLtr rL
Driveway
Permitl
Exempt
NOTICE
Authoritv. 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
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 approvalof this Application, a Building Permit will be issued granting permission to me, as
Ownel to construct the structure(s) and facilities detailed on the submittals reviewe'd by the Building Division. ln
consideration of the issuance of the Building Permit, lagreethat land myagentswill complywith provisions of any
fcdcral, statc, 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 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
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 Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
\5 t,I
Property Owner Print Sign Date
Permit #:
)
OFFICIAT USE ONIY 5
(narirl fnnr{ifinnc.rr€3rsr
Adjusted Valuation:Plan Check Fee 't'6'6"po Manu, Home Fee:Misc. Fees:
Total Fees: ^.too.@ Fees Paid:r@ ps Balance Duerb*ffib-%go OWTS No:
Setbacks:OCC Grouo:FAA- Llllt ,
Const.fype:-v)lu ,Z$qing:,--d4JJ)
5-B"tS
Date
BUtLDtNG / PLANNTNG DtVtStON
Signed Approval