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Clty Of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDfNG PERhUT AND CERTiFICATE OF OCCUPANCY %` �
Off-Street Parking
Applicant comptete this part ot form only. — CLASS OF WORK — � (No.Cars)
Press tlrmly using ball point pen. Interior Lot
Ne rAltetation Addition �emolish Move �
dob Address ���ii � t� �,T � � � � � � � Comer Lot ❑
�` Jfle�TuJc•vc
F -T Pibg. Mech. Eiea Struct. Rre Prot. Reversed Corner Lot � ❑
Name ��EiF'i f.�:.r�I$�f�iltlL�e �N� ❑ ❑ ❑ ❑ O �
m Mail Address ��'�� ����f�� �J�: � Oca Gc -3 Type Const, - Use Zone (r
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O Z�iYt (�� `' �u , + ,/��'g--� 'Use ot Buitding ' S (=�
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Phone [;.�� ��''���f FloorArea ��g� Height ;^.o
Name �p'� /' .�s � No. Stories ���y Lot Area Prontage y � a3 `I`
�9 �JEf 4' i C�r7 S�I'd :.c C-�f d k ,.4�-eiJC.. ? � .s
m Address ��s�r ��,y r! /�,3-e" i' Occ. load Oca Change trom �
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� ' ¢^ � r-,^�) Plai Fiie No. �jla%� r No. D.U. ) / � � �
o ��-ri�:i. S f!ry (. z�' l!!7 J `� t io 7 t .�1
U License No. �� � � � Phone �: •����1����� ' Garage area �� Fin. Bsmt. area .�! �—� �—�
° Lot ��.y Block Fiting Number - � Type heat No. Pireplaces or stoves � m -�.o d
a — FEIEASES — Dates t° > N
� Subdivision ��,j•f� ���� �l �
° PU� Zoning G�� ��t� S a73- �� o�) I o
LL
� Parcet k / .. ��G` Engineering , ��
OESCRIPTION OF WORK Fire Department � �
� tt3 fl G �!/ E? Electric Department Street ������ 's6't'..�15
F},FF� t,?zi.f?f1
water & Sewer i vA�(�M �y7� ��
Plan fieview �} /� �L.j�, '� � S(CSVti LJJ.UU
Speoia�Conditions: U�'��`� ���•��
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. _ / _ __� l � > fv�n��� nry,i�! i
Valuation ES t#N' '^^ �''
t Plan Check � ,".
F� Stock Options Permit � -
Plan No. � Codes Parklantl�
� ,A-�,,�
1Est.TotalCost -� ��� �'�d""'� CitySalesTax i ZBACase!! Date
�mclutling labor, material�,protif) St. Oversizing ggqCasek Date
Water Plant Investment �
l I hereby acknowledge that I have read this application and _ _ " -Z Building Insp. �"1 Approval
state fhat the above is correct and agree to comply witb ali city , Sewer Plant Investmenf �'� n�p �',��7 by � date �
ordinances and state laws regulating building construction. Storm Orainage !�
� � r T � Electric Underground �'J _�'�•{`> r'� J`���� � � „
ffi,�.��€ ��-�.�-�n:-� --��*�f� � �.r�'.-�
�I signed , - •.t1\,�j � fdste�s�, ` � ,TotaPF,eys� PeYriiit,No.�'� ' Daisc. . �
Disvibution.Onginti�Appltcant 91ue-0ii ce;Cenary-Seles Taz,Plnk+Appllcant;Tag-Bltlg-Insp. v �� 4 J
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