HomeMy WebLinkAbout169 N College Ave - Permits/Other - 12/13/1983Y
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ity 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.
Jab Address i y,A0- Cot t t-,G-E
Name a• +c t r'
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Mail Address ff
Phoney
Name f +F
Address -'
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License No. ,` L
Phone . _ • L
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Lot
Block
Filing Number
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Subdivision
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PUD
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DESCRIPTION OF WORK
i3OCAI tR.e ALA?. n -
Stock Options
Plan No. Codes
Est. Total Cost + - • r .-
(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.
signed t i 'date'•
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. - Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Occ. load
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 & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit_
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Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
_
Sewer Plant Investment
Storm Drainage
Electric Underground
`Total,Fees` ?�": i
O�stnbnon. Onginal - Apphcan Y, 5We- Office: C.A,d - Salea Tax: PmA - Applmanb Tag --Bldg-;nap.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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ZBA Case #
Date
BBA Case #
Date
Building Insp.- - Approval
by date
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P rgrt No. )
Date
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