HomeMy WebLinkAbout1418 Clementine Ct - Permits/Single Family New - 08/28/1986of- Fort Collins BUILD I'WG-31NSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 44,r1v14r11e.
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Name
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Mail Address
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Name
Address
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License No. y�..�.+�J Phone
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Lot i�05 Block r„•"�" Filing Number
Subdivision
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Parcel # ? ;xa- 19-;L—
DESCRIPTION OF WORK
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X/4-Si ¢�
Stock 7 Options
Plan No. Codes
Est. Total Cost Cd
(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
ordinances and state laws regulating building construction,
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signed '>\ '� dtate-"%
— CLASS OF WORK —
Newr -%Alteration Addition Demolish Move
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PI Mech. /Efec:_ Struct. Fire Prot.
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Occ" jGr. �� Type Const
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Use Zpne it �-0
_Use of Building `�,LLSL Yam,
Floor Area
Height %
No. Stories .A
Lot Area ��jjj too
Frontage 69-1�4
Occ. load -
Occ. Change from
Plat File No. f 4'-
No. D.U.
Fin. Bsmt. area
Garage area z1b6.
Type heat G/ ryl(e
Ngireplac se or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation ' %�` �' '� /% _ FEES
Plan Check
A112,r
Permit
Parkland
City Sales Tax
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St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
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Electric Underground
Total N6s,
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Distribution: Original - ApPlicanf Blu flee: anary� sales Ta+'Pink - Applicalt:-Tag-\altlg. Insp.)l »• `"'�-�—N
Off -Street Parking
(No. Cars)
Interior Lot
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Corner Lot
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Reversed Corner
Lot ❑
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Street
STDVR 575.00
VGE};C 279.00
T4TL 2023.28
CHCK 282.
No1822
15:58 A
AUG.28'86
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ZBA Case #
Date
BBACase# f ,
Date
Building Insp. -'
Approval
by
date
Date
28