HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
l970l94s-82L2
www.garfieldcountyco.gov
WPE OF CONSTRUCTION
BUITDING PERMIT
APPLICATION
DemolitionCommercial/M ulti-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
I ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Email Address:
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Phone: ( Yfq SlQtvcciProperty Owner:
Mailing Address:
OL(
,ry\
tilo ) ,non.'Contractor:
Mailing Address:
Email Address:
Phone:IArchitect:
Mailing Address:
Email Address:
Ensineer: Phone:
Mailing Address
Email Address:
Phone:Manufactured Home lnstaller:
Mailing Address
Emall Address:
PROJECT DETAILS
Owner's Valuation of Work:
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Heightr
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Describe Work:
Assessor's Parcel Number:
Property Size (Sq. Ft. or Acres):
f of Floors:_Sq. Ft. of Building
Job Address:
Block _Sub. Lot
Remodel/Alteration f lnooitionClass of Work:New
Attached DetachedGarage:
Septic:
Type of Heat:Natural Gas Propane
PROJECT DETAITS CONTINUED
Community
Electric Other
Driveway
lgr-mit;
NOTICE
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Authoritv. ThisapplicationfcraBuildingPermitmustbesignedbytheOwneroftheproperty,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.
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, I agree that I and 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 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 BLrilding
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
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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
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
provr the required information which is correct and accurate to the best of my knowledge.
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Owner Print and Sign Date
Permit #:
OFFICIAL USE ONtY
Special Condltlons:
Adlusted Vaiuation Pian Check Fee:
e--'i'Airypo Manu, Home Fee:Misc. Feeg-
Total Fees: -.\cn.du
Fees Paid
l\ /l.l @ Ba Due:ff.t',ICAK OWTS No:€
Setbacks:OCC Grouo:,-; /t h-\ )/Lt -
Const. Tvoe:
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Zoningit , ,-qT IJ-,
BUtLDtNG / PLANNTNG DtVtSt
Signed Approval Date