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'ìlrtrl l¡\ll f1/ ili:\l: Ì ?(Development Department
108 8th street, Suite 401
Glenwood Springs, CO 81601
19701945-82t2
www.garfield-cou ntv.com
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Garficld Counîy
BUILDING PERMIT
APPLICATION
E Demol¡tionE Commercial/Multi-Family
.E Manufactured Home (Single or Multi-Level)
ReroofE Residential (SF, Duplex or Townhome)
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Property Owner:Ðhan"l T/ aøt rtç Phone:?)
Email Address:
Mailing Ad
Email Address:
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Phone:Contractor:,ryã
Mailing Address:
Email Address:
Phone: ( )Architect;
Mailing
Mailing Address:
Email Address:
,z|,la a-J )Phone:(Engineer:
í"an,
C/lLL
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Lot Block
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Height:
Phone: I IManufactured Home lnstaller:
Describe Work:
Assesso/s Parcel Number:
Un¿?e
Job Address:
# of Floors:_
Size (Sq. Ft. or Acres):Owne/s Valuation
Sq. Ft. of Building:
of Work:?ì
Mailing Address:
Email Address:
! nepair Move/RelocationNew!Alteration ll RdditionClass of Work:
I DetachedGarage:!ettached
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PROJECT DETAITS CONTINUED
Septic:OWTS Community
Driveway Permit:Exempt Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,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 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 andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the uired and accurate to the best of my kn
Property Owner P nt and Sign
l_l Electric OtherI Natural Gas PropaneType of Heat:
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, lagree that land 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, 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 Build¡ng
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
or builderengineer
CERTIFICATION
d
OFFICIAT USE ONtY
Special Conditions:
Manu home Fee:Misc Fees:Plan Check Fee:Permit Fee:Adjusted Valuation:
Balance Due:BP No:42E-Ll+K OWTS No:Total Fees:
+L
id:aFees Pa
Const Type Zoning: PuÞSetbacksOCC Group:
BUITDING / PTANNING DIVISION :
Signed Approval Date
?D.TL.3l ,)It,+
Garfield County SINGLE FAMIIY OR DUPLEX
BUILDING PERMIT
APPLICATION CHECKLIST
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
www.garfield-countv.com
S¡NGLE 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.
o Owner's name, mailing address, phone, fax or cell.
. Contactors name, mailing address, phone, fax, or cell.
. Architect and/or Engineer's name, mailing address, phone, fax or cell.
o Building size, height, number of stories and lot size.. Use of building (Residential).
. Class of Work (New, Addition, Alteration, Repair, Demo, Move/ Relocation).
o Detailed description of work.. Type of heating (natural gas, propane, electric, other).
. Sewer system (Gommunity or OWTS), also see other items below.
. Garage (Attached or Detached).. Driveway permit (please see other items below).o Valuation (labor and materials), see attached worksheet.
OTHER ITEMS:o 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 with 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.
r lf you belong to a Homeowners Association (HOA) it is your responsibility to obtain written
approval, if required.o Provide copies of any Resolutions and/or Land Use Permits associated with this property.
. Additional Dwelling Units may require Administrative Review.
. Minimum dwelling dimension is 20 ft. wide x 20 ft. long.
. A Colorado State Licensed Electrician and Plumber must perform installation and hook-ups,
unless the homeowner is performing the work.