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Clty of Fort Collins:- BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
I
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 4143 Tanager Street
Name Pulte' lottie Carp
a`)
c
Mail Address 1 250 E. Miff Ave
o
Aurora, CO y0
Phone 751-3700
0
Name Roy Kahler
t
Address 5129 W. County Rd. 050E
o
Bellvue, CO 80512
o
— License No. n 29
u
Phone 223-9913
2
Lot 8
Block 3
Filing Number AlIll
Subdivision Larkborotigh
Nq
PUD
N
DESCRIPTION OF WORK
Plan 402 elev. A 23,805
i?. 2 car garage 19121
F. rear cant 271J
S. patio door 17U
Stock 182 Options P * g
Plan No. Codes_
Est. Total Cost 25,446
(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 Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const
Use Zone f'
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
T014 Fees
Distribution: Original - Applicant; Blue - Office; Canary - Sales Tax', Pink - Applicant, Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
M
Corner Lot
❑
Reversed Corner Lot
❑
m
c
"V r
4
in
in
c..
O
LL
s
Street -
0
0
all
ZBA Case #
Date
BBA Case #
Date
Building Insp. - Approval
by date
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�Dj" If 3
Permit No.
Date