HomeMy WebLinkAbout2121 Clearview Ave - Permits/Reroof - 05/06/1987City 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.
Job Address '� C' E
Name v
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Mail Address O
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Phone a
Name s'
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Address S'
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license No. Phone
Lot
Block Filing Number
Subdivision
PUD
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Parcel !<
DESCRIPTION OF WORK
P o—A
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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
ces and sta yvs regufat, g building construction.
I
signed datel
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
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 FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
'
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
IN
. Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
PRMTS
20.50
TAXPM
15.95
TOTL
36.45
CHCY, 3
H29776 23:04 A
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MAY.07'87
a
ZBA Case #
Date
BBACasSAo
Date
Bull
rlspl Approval
lb
iV date
21
C
Permit No.
Dalie
.45
Distribution: Original - Applicant Blue - Office; Canary - Sales Tax; Pink - Applicant: Tag - Bldg. lass,