HomeMy WebLinkAboutApplicationECGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfieldcountyco.gov
TYPE OF CONSTRUCTION
= Commercial/Multi-Family
Manufactured Home or Tiny Home (Single or Multi -Level)
0 Residential (SF, Duplex orTownhome)
1 Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
Demolition
Reroof
r INVOLVED PARTIES I Co
v s Q`J f� �/ -
Property Owner: L4i01 (C C,o i C Phone: ( ` () _1_ 61 U O � I
Mailing Address: Giti hY,2 1'1 / C C ( �r ��i1 V640—W-1401
Email Address: RI cl,m,QC7'�i1Lu) cum
Contractor: i • + Phone: �) L4 1 -QU�
Mailing Address: I 1 TU 7oiv 1L� 11
Email Address: I v
F
Architect:
Mailing Address:
Email Address:
Engineer:
Mailing Address:_
Email Address:
Manufactured Home Installer:
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work:
Job Address:
Assessor's Parcel
Y AAC)or
Phone:
Phone:
Lot L Block
Phone:
Owner's VaPuation of Work:l $ Property Size (Sq. Ft. or�A]cr s):
Sq. Ft. of Building: ��"l Height: # of Floors: f V
Class of Work: ; New IF
Remodel/Alteration Addition
Garage: Attached Detached
601
PROJECT DETAILS CONTINUED
Septic:
❑OWTS
Type of Heat:
-
❑Natural Gas
Driveway
Permit:
IF]
❑ Propane
IJ Community
F-1 Electric
❑ Permit #:
❑ Other
—j
NOTICE 1 _
Authority. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by
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 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 j
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. In
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.
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 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
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.
hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
p7'Z7
e quired information which is correct and accurate to the best of my knowledge.
[ ( �
opertyOwner Print and Sign Date
OFFICIAL USE ONLY
,
12/2
d
•f'
p0
Special Conditions:
Adjusted Valuation:
Pla Check Fee:
Permit Feed'
Kan . Home Fee:
JA
Misc. F s:
Fels Pai
VU
Total
Balance ue:
BP No:
bWS No:
Setbacks:
OCC Gro
Con
T��/
� n
BUILDING / PLANNING DIVISION: 604fil
A* A A—o
if I
Signed Approval
Dat