HomeMy WebLinkAbout4100 Mount Vernon Ct - Permits - 09/05/1986City 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 L4/cc -{- t i C
Name • �+, C4- e.('S
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Mail Address
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Phone �.
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Name d
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Address
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License No. f rj
Phone
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Lot
Block
Filing Number
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Subdivision
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PUD
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Parcel #
DESCRIPTION OF WORK
>-f
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
ordinances and state laws regulating building construction.
signed date
— CLASS OF WORK —
New Alter ti Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. M ed6fi Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gt.
Type Const:
use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Occ. load
O6c. Chafe 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
Distribution: Original - Applicant. Blue - Office'. Canary - Sales Ta*. Pink - Applicant Tag - 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 date
Permit No.
- Date