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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www. garf¡eld-countv.com
Gørfield County
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential {SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES /t t
Phone:
QO
\r
orEmail Address:
Property Owner:
Mailing Address:
Phone:Contractor:
Mailing Address:
Email Addressl
o
Phone:,\rn, (oíF' L b? 0Architect:
Mailing Address:
Email Address:
/fa\ c/pnon".r
Mailing Address
Email Address:
Engineer:
Manufactured Home
Mailing Address
EmailAdd
PROJECÍ DETAI¡.S
Describe Work:
oo
t-
Lot x
Height:
Property Size (Sq. Ft. or Acres)
("
of Work:
BlockSub.
fiof
Assessor's Parcel Number:
Job Address:
Owner's Valuation
Sq. Ft. of Building:
X Remodel/Alteration AdditionClass of Work:New
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Community
NOTICE
Authoriw. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
or an authorized agent. lf 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 ìf 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 L80 days after commencement.
CERTIFICATION
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
the red correct to the of knowledge.t,J"0 e&
Property Print and Sign
IXSeptic:
Electric OtherNatural Gas XlnroRaneType of Heat:
Permit #:Driveway
Permit:
pt
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)). I acknowledge that the
Building Permit may be suspended or revoked, upon notice from the County, if the location, construct¡on 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 npplication, 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
desi or buildereneer a
OFFICIAL USE ONTY g
6æazhtulØA4b/TA ISSpecial Conditions:
Permit Fee'. :ttt1,294.72 Manu. Home Fee:l..ìIN,
Misc, Fees:ñlr4Adiusted Valuation:lll- 2¿noo "ëää.nt:2
Balance Due:BP No':
TAE -+5q t
Total Fees: .â
?-. 1u,t /Fees Paid:$83s,al
Zoning:,t<o'wpþ-,*ïT?Lsetb#ks
7-lî-22BUILDING / PLANNING DIVISION
Signed Approval Date
&//,
Gurfield CounQ
B'IILDING DEPARTMENT
708 Eighth Street, Suite 407, Glenwood Springs, CO 87607
Tel: (970) 945-8272
PLAN R EVIE W CHE c KLIST
Permit No: I ¿R€-& -Z-7r9/
^tàr-- Surveyed Site Plan
14€1,ffikffi^H?z
Building lssues
Engineered Foundation
Dríveway Permit
--- Grade/TopograPhY30%
Attach Residential Plan Review List
-/ Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
-."/ Attach Conditions
PlanninglZoning lssues
Nft
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Grade/ TopograPhY 40%
Planning lssues
Subdivision Plat
LilSqî? Ø,'**)
7.?Øaues
Descri Summa
Road rmpac tr"þo hahib l¡'V,ry)
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Mtr
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Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No.
40# Snowload Letter - Manu' Homes
Soils Report Ya/uah'd-zt
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Gørfield County SINGLE FAMILY OR DUPLEX
BUILDING PERMIT
APPL¡CATION CHECKLIST
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.garfield-cou ntv.com
SINGLE FAMILY OR DUPLEX BUILDING PERMIT APPLICATION CHECKLIST
ln order to understand the scope of work intended and to expedite the issuance of a permit, it is
important that complete information be provided. Please review this document to determine if you have
adequate information to design your project and to facilitate a plan review.
APPLICATION FORM: Please make sure the following information is provided on the application
. Parcel number obtained from the County Assessor's Office.
. Job address (assigned physical address). Legal Description: block, lot, tract, subdivision, filing, or section, township and range.
. Owner's name, mailing address, phone, fax or cell.
. Contractor's name, mailing address, phone, fax, or cell.
. Architect and/or Engineer's name, mailing address, phone, fax or cell.
. Building size, height, number of stories and lot size.
. Type of Construction (Residential).
. Class of Work (New, Remodel/ Alteration, Addition, Repair, Move/ Relocation).
. Detailed description of work.. Type of heating (natural gas, propane, electric, other).
. Sewer system (Community or OWTS), also see other items below.
. Garage (Attached or Detached).. Driveway permit (please see other items below).
. Valuation (labor and materials), see attached worksheet.
OTHER ITEMS:. WILDFIRE MITIGATION - All Garfield County property owners are recommended to employ
wildfire mitigation strategies in the development and construction of all buildings throughout the
County. Please refer to the following publication: "FireWise Construction: Site Desiqn & Buildinq
Materials" which is available from the Colorado State Forest Service for specific wildfire mitigation
strategies applicable to your project.
. lf you anticipate obtaining a water-tap from the City of Rifle, please provide a letter indicating that
the City will provide water service. Required to submit building permit application.
. OWTS requires a septic permit application to be submitted g,i!! the building permit application.
. A separate electrical permit must be obtained from the State of Colorado Electrical Board.
. At the time of building permit submittal, you are required to show proof of legal and adequate
access to the site. This may include proof of right to use a private easement, County Road &
Bridge permit, or Colorado Department of Highway permit, including a Notice to Proceed. The
County Road & Bridge Department can be reached at 970-625-8601.
. lf you anticipate excavating or grading prior to issuance of a building permit, you will be required
to obtain a separate grading permit.
. lf you belong to a Homeowners Association (HOA) it is your responsibility to obtain written
approval, if required.. Provide copies of any Resolutions and/or Land Use Permits associated with this property.