HomeMy WebLinkAbout1090 E Elizabeth St - Permits/Addition or Alteration - 03/23/1987''!City of Fort- ' Collins y'BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
- Press firmly using ball point pen.
Fir
Job Address / _
Name
c
Mail Address t
3
O
Phone
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Name
.ro
Address a
c
a
U
License No. � 3
Phone
c
n
Lot
Block
Filing Number
Subdivision
PUD
m
,Parcel # o
DESCRIPTION OF WO f -
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
1 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.
1
sigPed d e
1
— CLASS OF WORK —
New AI ra ion Addition Demolish Move -
❑ ❑ ❑ ❑
le Struct. Fire Prot.
wo ❑ ❑
Occ. Gr Type Const.
Use Zone
Use of Building
Floor Area Height
No. Stories
Lot Ar
Frontage :!
Occ. load
h fro
P I N
. D.U. (4
a area
Fin. Bsmt. area -
Type heat T
No. Fireplaces or stoves
— R EASES — Dates
?
Zoning L 7—�
Engineering
Fire Department
Electric Department
Water R Sewer
Ian Review
Special Conditions:
Valuation FEES
Pian Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant investment
Sewer Plant Investment
Storm Drainage
Electric Undergrountl
Total Fees
-
MW
Off -Street Parking
-
- - (No. Cars)
Interior Lot -
❑
Corner Lot -
❑
Reversed Corner Lot
❑
0
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5
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LL
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Street
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TOTL
93.22
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N28231 18:06 A
MAR.2k'87
ZBACase# (
Date 3—/}
SBA Case #
Date
Building Insp.
Approval
by
date
Permit No.
Date
�2
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Oil:tnbvtion: Original - Applicant: Blue - Ofl'M Ganary - Sales Tax: Pink - Applicant, Tag - Bldg. Insp.