HomeMy WebLinkAbout128 W Lake St - Permits/Demolition - 06/15/1987city
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 2
Name ' A
c
Mail Address
3
O
Phone end
Name �� r
o
Address
c
0
License No.
Phone
Fi
Lot Block-
Filing Number
Subdivision
PUD
m
�
Parcel N
DESCRIPTION WORK
'01C %_ O
Stock - Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
Fereby acknowledge that I have readthis application and
hat the above is correct and agree to comply with all city
nces and state laws regulating building construction.
gned ate
— CLASS OF WORK —
New Alteration Addition DerVoli§4 Move
❑ ❑ ❑ ❑
Plbg. Mach. Elea Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
outage -
Occ. load
c.
a* fro
Plat File No.
No. D.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
4r,":9
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
D etra, t&�eti;'ginal - AOplicanp Blue - Office', Canary - Sales Tax, Pink - Applicant. Tag -Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
m
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PRMTS 10.
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n
JUN.16'87
Street
C
0
D
ZBA Case#
Date
B BA Case N
Date
Building Insp.
proval
by
date
Permit No.
Date
ty of Fort ColI1riS 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 Az, Prq 1",p
Name,,
m
Mail Address
c
3
O
Phone
ti
Name �tj � �-.c.✓ f-c'r, .�!%i'
o
- -
Address
c
0
0
License No. 1 ZZ yj Phone
°
Lot Block Filing Number
n
g
Subdivision
ar
PUD
Parcel If
DESCRIPTION O -WORK
Stock Options
Plan No. Codes
Est. Total Cost
lincluding labor, material, profit)
I hereby acknowledge that I have read this application and
stale that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
to
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ �..y ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area Height r
No. Stories
Lot Area "�
Frontage f
t
Occ. load r
Occ. Change from,"',
Plat File No.
No. D.U.
Garage area �
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water 8 Sewer
Plan Review
Special Conditions:
� !J
Valuation ,il ;(� '- FEES
Plan Check
_
Permit
Parkland
1411,/- '
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
TotaLFees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m
I�
`m
�
D
d
to
;
TDTI_ ?3VuD
! tlrlc
.4Pt1`?10 20�_9 A
Street 11cu r%'n'f
`o
m
a
m
ZBA Case R Date
B BA Case N Date
Building Insp. Approval
by �^^ ,rdate
Permit No.-
r�.Date
-
Dislribulion..O al- Applicant Blue'>Offiiel Canary - Sales Tax '.Fnk',ApplicantI Tag -altlg..lnspA `�`�. %