HomeMy WebLinkAbout1412 Buttonwood Dr - Permits/Reroof - 09/24/1986city
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Of Fort COl11nS 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 .. a 9 - - � .
��
Name f , rin, h'_.'• e ti
Mail Address 1
�,rr'-,,_
Phone
Name r.r"~{'
ro
Address
U
--
License No. l f
Phone „ t"
2
Q
Lot
Block
Filing Number
N
Subdivision
PUD
m
Parcel #
DESCRIPTION OF WORK
y°
re
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
nces and laws regulating building constru(ccttti(on..
Ijstate
Jofrrdddii}n
y
signed ��� �°`._"'.•, t "�f�ate
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ p ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
UsejZone
Use of Building
tt t
Floor Area t Height
No. Stories
Lot'Area�.-' i
Frontages
Occ. load , `
Occ. Change froms
-
Plat File No.�
v
NoU!
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:
Valuation FEES
Plan Check
Permit
'
Parkland
, --•
City Sales Tax
_
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
- . r --. -- --- _
��oYai•-l;ees �,
W,
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
a
td
m
a�
m
_IV
to
M
c
0
li
Street
c0
> r•z -
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by ----date
�- \Permit No..4 ---
Date
Distribution: Original -Applicant: BIUes�OfticB`Ca�ary - Sales Tax; Pink - ApplicantaT�q,�.p g. insp.