HomeMy WebLinkAbout1112 Birch St - Permits/Addition or Alteration - 07/27/1982CITY OF FORT COLLINS
APPLICATION FOR BUILDING PERMIT —SHORT FORM
Building Address
Date of Application 19
Name
3
Mail Address
O
City Tel. No.
o
Name
6
to
Address
City
U
City License No. Tel. No.
Occupancy Group A, B, C, D, E, F, G,
H, I, J Division 1, 2, 3, 4
Use Zone —RE, RL, RLM, RM, RH, RP, RMP
ML, MM, BP, BL, HB, BG, C, IL, IG
Fire Zone 1, 2, 3
PUD
Signature of owner
By Contractor
Class of Work
Plumbing
_Roofing
Heating
_Fencing
Electric
—Sprink.
Gas Pipe
_Storm W
Sign
_Other
Permit No.
VALUE
I nt. lot
Total Value Labor & Mat. Corner lot
Description of Work
Date issued
Bldg. fee
Other
Total
Rev. C. L.
I
Street
Approved for Chief B.I.
Zoning
City of Fort Collins CO
J
BUILDING PERMIT NO. "
g
Estimated cost of
J �
Labor and Material
- �^•-. -
Date J..+.•- �
Permit Fee-
1 L
Plan Check Fee ' U•a
<+
i J I, hereby authorized to:
•
• .. .(names
'
-
Work In :: .,` .. „
Progress Fee
..
�� "
. ❑Enlarge ❑Erect 'Pair El ❑ Demolish
+
.Street Oversizing-
Structure At pe,
p
Park Land Fee --
ADDRESS
Storm Drainage Fee
"
.- Legal Description: Lot Block. ._Occ Gro el Const.Type
Zone Dist. ''• - Subdivision . >' •.._10: .. .
. , .-. ...,
.... Useof 81dg ^"✓' }. < '�)•-''e^ a. r c. 8 ;,
' TOTAL DUE
'"��"%'`r-"'x�'�-�� ai ".'z'"f ""-r %"��^S'.•0^'r'
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DescripttonofAuI orizedWork
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Special Conditions of Issuance
j L
an SSUMB all
CONTRACTOR'S STATEMENT As the duly licensed contractor for the above work'rl understand -the limitations of sa%bn
- responsibility for the work authorized hereunder and further acknowledge that fraudulent use orfending license to
. of such ti r an
-. Con tr ctor actuall per orrm,Jr�ng the Zk, may be cause for revocation and other penalties (Sec. 73-T24 Municipal Code)
",(Contractor) ',
- Thispermit is Issued on the express cometionthat the
_ (Lic No) ,, I t- i-{Signature o1 Authorit)
. Work hereby authorized shall in all respects conform to
}
the statements certified in the application for such
WiUlamE. Waldo _
permit and that all work shall be done in accordance with
the ordinances of the City of Fort Collins and the laws of
Chief Building Official - "� "' �i ;.-� byhe
-
State of Colorado. The granting of this permit does-
not give the authority to violate any ofthese regulations.
PERMIT BECOMES VOID- IFJAUTHORil{ED.WORI["IS NOT COMMENCED WITHIN 180 DAYS
.', White Sales Tax; Pink
-Counter Yellow - Appiican[ Green . Bldg. lnapechor; Blue - Sales Tax - -