HomeMy WebLinkAbout4133 Sumter Sq - Permits - 04/22/1986City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERhUT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address -A41 22.
Name J '+r
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Mail Address
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Phone
Name
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Address.-
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License No.
Phone
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Lot
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Block
Filing Number
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Subdivision
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PU
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Parcel #
DESCRIPTION OF WORK
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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
ordinances and state laws regulating building construction.
signed date. \
— CLASS OF WORK
New Alter lion Addi Demolish Move
❑ ❑ ❑
Plbg. Mech. Elec. Struc . Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr.
Type Const. Use Zone j
Use of Building
Floor Area
yeight
No. Stories
Lot Are
Frontage
Occ. load
04. Change fro
Plat File No.
No. O.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning 1
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
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Valuationli` / FEES
Plan Check
Permit
Parkland
City Sales Taxes
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
tal F9es
f
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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ZBA Case # Date
BEA, Case # Date
Building Insp. Approval
by : date
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Date
Dis:ribunorr. O; iylnal - Applicant, eiue - OfTILU, Canary - Sales Tax; rink - Applicant. Tag - Bldg. Insp.