HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-8212
www.garfieldcountyco.gov
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BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCIION
Commercial/Multi-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
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^Ya/aContractorPhone
')t ?a tr_16 {2Mailing Address:
Email Address:
Phone:Architect:
Mailing Address:
Email Address:
Phone: (_)Engineer:
Mailing Address
Email Address:
Phone: ( )Manufactured Home lnstaller:
Mailing Address
Email Address:
PROJECT DETAILS
Describe Work:
Sq. Ft. of Building:
Iot
Height:
00/)
Owner's Valuation of Work: S
L{20
T'e^r n€€ Ro-,V
OLJob Address:
Property Size (Sq. Ft. or Acres)
# of Floors:_
Assessor's Parcel Number:
Sub.Block _
Remodel/Alteration AdditionClass of Work:New
Garage:Attached Detached
Y
PROJECT DETAI tS CONTINUED
Septic:
Natural Gas Propane
NOTICE
Authoritv. This application for a Building Permit nrust be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
legal Access. ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
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
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 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 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
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
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
required information which is correct and accurate to the best of my knowledge
Property Owner Print Date
Type of Heat:
Driveway
Pe rmit:
Electric
Community
Other
n Permit #:
OFFICIAT USE ONtY I
Snecial Conditions
Adjusted Valuation:Plan Check Fee:Permit Fee:lr)(:) 9a Manu, Home Fee Misc. Fees:
OWTS No:Total Fees:
loo.oo
Fees Paid\.ti.oo Balance Due:a-BP No:
ffi'-,F 9%l
Setbacks:OCC Grouo:+0ll Type:
n
Const.+9 '$ii,o
BUILDING / PLANNING DIVISION :
DateSigned Approval
78A6-