HomeMy WebLinkAbout2608 Leisure Dr - Permits/Reroof - 09/05/1986City of Fort -Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name �fr e
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Phone --/ 4
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Name 4_.LAe7)
Address
License No. / -3
Phone 4J/9F3-4 7,41q
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Lot
Block
Filing Number
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Subdivision
PUD
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Parcel #
DESCRIPTION OF WORK
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7, alb .ar 11'is_mvi
14-1
Stock Options
Plan No. Codes
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Est. Total Cost .....
(inclrjding labor, material, profit)
hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinaices and state laws regulating building construction.
signed (' �,`t � :;,L (d"ate-A{
— CLASS OF WORK —
New Alterat •• n Addition Demolish Move
❑ @' ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building S r
FloorArea
Height,.1
No. Stories
�otrA ea W
, yA, a
(Frontage
Oc wjoad &
'rOcc. Change from
Plat:�il Q f Y
IVo. D.U.
Garage)ar a ..
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
_
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
TOtal_FeeS-,;
Distribution: Original - Applicant 'Blue - Office; Canary4'Sales Tax; Pink - Applicant; Tag,- Bldg:-Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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("slit
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
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by date
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Permit No. `
Date