HomeMy WebLinkAboutApplicationr
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108 8'i' Slreel, Suite 401, Glenivood Springs, CO 81601
Ph. 970-945-8212 rx.~970-38.1-3440 Inspection Line:888-868-5306
www -e 1t1-1eld-counh .Com
BUILDING PERMIT APPLICATION
I
Parcel No: (this informatinn is arwilahle at the ucsesuhrs r jjice'170-945.1/34)
1
Lot No: Block No: Subd./ Exemption:
21 — — '7 Jq
Z T, W. Mleak r
2
Job Address: (ifan address hat nut been aceigner4 please prowde C'iC HII'd' orStreet Name & 01y) or and legal description
Permit Fee:
i ' , D lb S
3
Owner: (prvI rtyoNner)
Mailing Address:
Ph:
Alt Ph:
7z. yo
S rr ,C rr?1rfjnrojJCJ441
cr.i-Tharp f sz n. (le co
— S,yq
4
Contrac or:
Mailing Address:
Ph:
Alt Ph:
w1i,re. 7ubt11 ✓ -e ; e-
i -b C i i o% 1% Fle cC`
9712- 2 -- 2
7J7 ��
5
Manufactured home installer:
Mailing Address:
Ph:
Lic #:
6
Architect:
Mailing Address:
Ph:
Alt Ph:
7
Engineer:
Mailing Address:
Ph:
Alt Ph -
8
Sq. Ft. of Building3g f t.
Sq, Ft, or Acres of Lot: R ��
Heightfry
No. of floors:
9
Use o1' Building:
Class of Work:
❑Residential ®Commercial ❑Other
QNew ❑Alteration ❑Addition []Repair ❑Demo []Move
10
Describe Work:
A PROVAL
DA E
11
Garage:
Septic:
Type of ficat:
❑Attached []Detached
❑ISDS ❑Community
❑Nat. Gas ❑Propane ❑Electric []Other
12
Driveway Permit:
Owners valuation of Work: r
NOTICE
Aulhori .'11tis application for a Building Permit must be signed by the Owner oftmc property, described above, or an authorized agent. hfilte signature below is not that of the Owner, a separate
letter ofoulhority, signed by the Owner, must be provided with this Application.
Lceal Arcess, A Building Permit cannot W issued without proorof legal and adequate access to the property for purposes of inspections by lite Building Department -
Other Permits, multiple separate perhils may be required: (I ) State Merica! Permit, (2) County ISDS Permit, (3) another permit required for use on the property identified above, c.g. State or
County Highway! Road Access or a Slate Wastewater Discharge Permit,
Void Permit. A Building Permit becomes null and void if lite work authorized is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a Belix( of 180
days after commahecment.
CERTIFIC><TION
I hereby certify that I have read this Application and than the infortuation contained above is true and correct. 1 understand that the Building Department accepts the Application, along with the Plans
and specifications and other data submitted by site or on my bdtalf(submitnals), based aper my certification as to accuracy
Assuming completeness oftbc submittals and approval of this Application, a Building Permit will be issued granting permission to use, as Owner, to construct the slructurc(s) and Facilities detailed an
tike submittals reviewed by the Building Department.
In consideration of the issuance of the Building PrnmiL 1 agree that 1 and my agents will comply Willi provisions of any federal, slate or local law regulating the work and the Garfield County Building
Code, ISDS regulations and applicable land use regulations (County Regulation(s)). 1 acknowledge that lire Building Permit may be suspended or revoked, upon notice from the Courtly, ifthe location,
construction or use of the strucluMs) and Faciliry(ics), described above, arc not in compliance with County Regulation(s) or any other applicable law.
I hereby grant permission to the Building Department to enter lite property, described above, to inspect the work, 1 further acknowledge that rhe issuance of rhe Building Permit does not prevent the
Building Official from; (1) requiring the correction of errors in the submittals. if any, discovered alter issuance, or (2) stopping construction or use ofthe structure(s) or racility(ies) if such is in violation
Of County Rcbnlatron(s) or any other applicable law
Review of this Application, including submittals, and inspections of the work by the Building Department do not constitute an acceptance of responsibility or liability by the County of errors. omissions
or discrepancies. As like Owner. I acknowledge that responsibility far compliance Willi federal, state and local laws and County Regulations rest Willi me and my authorized agents, including without
limitation my architect designer, engineer and/ or builder -
I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THC NOTICE &c CERTIFICATION ABOVE,
_ r —&—' - 1.-1
O1ERS SIGNATURE DATE
STAFF USE ONLY
Special Conditions:
Adjusted Valuation:
Plan Check Fee:
Permit Fee:
Manu home Fee:
Nlisc Fees:
IS S,53. za
7z. yo
2 6S. 2-5-
Total Fees:
jjfeces Paid::
Jul
Balance Due:
IIP No & Issue Date-,
ISDS No & Issued Date:
7J7 ��
�`I1�,�v`a
Lo�
Setbacks:
OCC Group:
Const Type:
Zoning:
�'z,�'',ers
5�0
5
BLD E
P G
'APPROVAL
DATE
A PROVAL
DA E
Building Plan Review
Description of Work: Covering for used oil storage
Bin #:
Location Address: 556 CR 352
RIFLE, CO 81650
Case Manager: David Bartholomew
Plan Cast Number. BLDG -3-12-7186
Parcel: 217919200718
Application Dale: 032V2012
Building
Engineered Foundation
Driveway Permit
V/ Surveyed Site Plan
f j Septic Permit and Setbacks
Grade/Topography 30%
Attach Residential Plan Review List
Minimum Application Questionnare
Subdivision Plat Notes
Fire Department Review
Valuation Determination/Fees
Red Line Plans/Stamps/Sticker
Attach Conditions
Application Signed
Plan Reviewer To Sign Application
Parcel/Schedule No.
/1 '4 40# Snowload Letter - Manu. Homes
N ,J Soils Report
Monday, April 2, 2012
ErEdMonmz 2*4V
Owner. STRATEGIC ONE FINANCIAL INC
Applicant: STRATEGIC ONE FINANCIAL INC
Applicant Phone: (702)334-8494 Email:
PlanninafZoninq
property Line Setbacks
30ft Stream Setbacks
Flood Plain
Building height
Zoning Sign -off
Road Impact Fees
HOAJDRC Approval
Grade/Topography 40%
/ Planning Issues
Subdivision Plat
General Comments:
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