HomeMy WebLinkAboutApplicationGarfield County
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970le4s-821,2
www.ga rfieldcou ntvco.gov
PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accesso Dwelli Unit - MAXIMUM SIZE OF SQUARE FEET
t-Gotnni ercr Crv'z- phone: (q?o) b3l-q}bZ-Property Owner:n Y\Ad I I P A n
Mailing Address:l33q O Yrhr*ri 4nre -Si 14. ca 9,ttasz
Email Address:n S l+i le @ l\vc Covh,
Contractori Phone
Mailing Address
Email Address:
Architect:Phone:
Mailing Address
Email Address:
Engineer: Phone:
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone:(
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:td
Job Address:lq4 Scol-1<-,r Ln. Ri€te .cO % llo
Assessor's Parcel Number
Sub.Lot Block
Owner's Valuation of Work:Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:# of Floors:_
Class of Work:New Remodel/Alteration Addition
Garage Attached Detached
PROJECT DETAILS CONTINUED
Community
Propane Electric Other
Exempt Permit #:
NOTICE
Authoriw" 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.
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
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.
Property Owner Print and Sign Date
ll'Septic:
Type of Heat:Natural Gas
Driveway
Permit:
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 issuanceof the Building Permit, lagreethat land myagentswill complywith provisionsof any
federal, state or local law regrrlating 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, 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
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lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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, ifany, 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
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.
oFFlclAt UsE oNtf p
Special Conditionsr
ffi1tfii-vaiuation
Pian Check Fee:\s lt}Permit Fee:
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Manu. ilome Fee:
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Fees Faid:656cc Balance Due:nri co' 1t1
BP NolwT,qqsq OWTS No:TTNTil] tt I
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z 1 a.ci1-1r-+)BUILDING / PLANNING DIVISION :
Approval
I
Date