HomeMy WebLinkAboutApplicationi Garfield County
Community Development Department
RIEGIEN ED 108 81h Street, Suite 401
,.,.,,.Glenwood Springs, CO 81601
` c .i ` i_I`P (970) 945-8212
GARi=1ELD a;q"? i w;Ww.garfieldcountVgco.gov
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TYPE OF CONSTRUCTION
❑
Commercial/Multi-Family
❑
Demolition
❑
Manufactured Home &Tiny Home (Single or Multi -Level)
❑
Fence
❑
Residential (SF, Duplex or Townhome)
Q
Reroof
❑
Accessory Dwelling Unit (ADU) - MAXIMUM SI2E OF 1,200 SQUARE FEET
❑
Siding
INVOLVED PARTIES 9�'1 ` —�
Property Owner: �5� ►'1 `- \ I e'r Phone: (L-To) cl
Mailing Address: i 2 c:-1 i eY,, Ec:Cc, I e Ci cc c-
Email Address:
Contractor: e-00 Phone: jq3
Mailing Address: Sc, Y\)t ce S (CC --
Email Address: 'e5-?5� c�rJ min �C roo�n�C1; .Cp yv�
Architect:
Mailing Address:
Email Address:
Engineer: _
Mailing Address:
Email Address:
Manufactured/ Tiny Home Installer:
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: !L�[
Phone: ( )
Phone: ( )
Phone: ( )
Job Address: 6C ,e- C Ir C, U vi
^� 4�u
Assessor's Parcel Number: C) R 2/
Sub. _ VC i( 'VC of Block f°�
Owner's Valuation of Work: $ � 00 C? Property Size (Sq. Ft. or Acres): lJ
Sq. Ft. of Building: 76-0 Height: # of Floors:
Class of Work: ❑ New ❑ Remodel/Alteration ❑ Addition ❑ Repair ❑ Move/Relocation
Garage: 0 Attached 0 Detached
PROJECT DETAILS CONTINUED
Septic: ❑ OWTS
❑ Community
Type of Heat: —1 ❑ Natural Gas ❑ Propane I ❑ Electric ❑ Other
Driveway ❑ Exempt — ❑ Permit #:
Permit:
NOTICE
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 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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required infor ation hich is correct and accurate to the best of my knowledge.
Property Owner r t and Sign Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
Plan �MFee:
Permit Fee:
Manu ho a Fee:
Misc Fees:
Total Fees: j
Fees Paid:
Balance Due:
BP No:
OWTS No:
Setbacks:
OCC Group: r
1
Const Type:
Zoning: Fv
.J
BUILDING / PLANNING DIVISION: ✓L°" /
IC �� Z�
Signed Approval
Date