HomeMy WebLinkAboutApplicationGarfuld County
Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
(970194s-82t2
www.garf ieldcou ntyco.gov
INVOLVED PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCNON
Commercial/M u lti-Fami Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
x Residential (SF, Duplex or Townhome)Reroof
Accesso Dwelling Unit - MAXIMUM SIZE OF SQUARE FEET
Phone: f 72b )'1j) - UD>t
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Property owner: gao.o (} cch o-c\
Mailing Address: t?St? (o
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contractor: Pa.^\ D".it R.tloo$ot rS ftar{l
Email Address:vl (o
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Mailing Add
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Phone:Architect:
Mailing Add
EmailAdd
Phone
Email Address:
Mailing Address
Engineer:
Phone: ( )Manufactured Home lnstaller:
Mailing Address:
Email Address:
Owner's Valuation of Work: S ,5D o D Property Size (Sq. Ft. or Acres)
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5
Lot
loors: ArHeight:70Sq, Ft. of Building:ZODr>
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#ofF
Sub.
Describe Workl ea.te (\ \
Assessor's Parcel Number:
Job Address
PROJECT DETAILS
R c,.non'c
Block
New {Remodel/Alteration
AdditionClass of Work:
DetachedGarage:Attached
Gn\a^.\o(
PROJECT DETAI$ CONTINUED
Community
Electric Other
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.
2 to LT
Owner Print Sign Date
Septic:
Type of Heat:ral Gas Propane
Driveway
Permit:
Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofarrthority,signedby
the Owner, must be provided with this Application.
Lesal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspeetions 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 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.
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, 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
acknowledgethat responsibilityforeomplianee with federal, state and locallaws and County Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
OFFICIAT USE ONIY
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Adjusted Valuation Plan Check Fee Permit Fee:^ ^-"tr'n L) \r Manu. Home Fee:Misc. Fees:
i7lH''.oo ooFees Paidlail Balance Due BP No:
w-j Llt,Llza4
OWTS No:
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7-te-5BUITDING / PLANNING DIVISION :
Date