HomeMy WebLinkAbout2110 W Elizabeth St - Permits/Footing and Foundation - 10/14/1986Clty
Fort Collins BUILDING INSPECTION DIVISION 4 V
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address r9iI t 0 W,
Name R
Mail Address ;_x .} f
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Phone
Name
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Address t s
License No. M.
Phone f
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Lot
Block
Filing Number
N
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Subdivision
PUD
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Parcel # I
DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
Est. Total Costf i
(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.
h signed ^- - _ r date
f — CLASS OF WORK —
N,ew Alteration Addition Demolish Move
O ❑ ❑ ❑ ❑
Plbg. Mech. 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 j' `,•,� ' :.` . ' FEES
-Plan Check
Permit
f
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total -Fees. �-
�.
Distribution: Original - Applican4:,61 ue -Office; Canary -Sales Tax:ink -Applicant �T.ag -`Bldg.-Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. ;';_ ;-- Approval
by y� i date
7
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Permit No.
y Date