HomeMy WebLinkAbout4117 Sumter Sq - Permits - 08/30/1985City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form umy.
Press firmly using ball point pen.
Job Address
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Name oL r
Mail Address
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Phone i
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Name G
V .ate
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Address
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License No.
Phone
4
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Lot
-
Block
Filing Number,
N
Subdivision
°
PUD
Oi
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DESCRIPTION OF WORK
Stock Options
Plan No. Codes ---
Est. Total Cost
lincluding labor, material, profit)
I hereby acknowledge that I have read this application and
Mate 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 Alteration
Addition Demolish
Move
Plbg. Mech.
C1 f]
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 frorn
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
f
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Water Plant Investment
Sewer Plant Investment
Storm Drainage Electric Underground
Total Fees
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Off -Street Parking
(No Cars)
Interior Lot
❑
Corner Lot
E3-
Reversed Corner Lot
❑
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ZBA Case #
Date
BSA Case #
Date
Building Insp. _Approval
by date
/9/0";
017s
Permit No.
Date