HomeMy WebLinkAbout417 W Magnolia St - Permits/Addition or Alteration - 03/11/1985City `Of Fort C611ins -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 4
Name
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Mail Address
3
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Phone
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Name
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Address
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License No.
Phone
C
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Lot
Block
Filing Number
Subdivision
PUD
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DESCRIPTION OF WORK
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 Alteration Addition Demolish Move
Plbg. ech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Dec. Gr. Type Const.
Use Zone
Use of Building 4•W-`�`
Floor Area wtn
Height
No. Stories
Lot Area1� 11
Frontage
Occ. load
Occ. Cha�g'e 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
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Plan Review Yz -i lit o
Special Conditions: /r
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
f t' --
St. Oversizing
"t
Water Plant Investment
Sewer Plant Investment
\
Storm Drainage
Electric Underground
It
Lotal-Fe�s�.j Lj-
Distribution: Original - Applicanq�9lue - O hce; Canary -Sales Tax; t ink - Applicant TagV Bldg. Insp.
/4
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. (7 Approval
by
date
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Permit No.
Date