HomeMy WebLinkAbout4414 Sumter Sq - Permits/Reroof - 09/02/1986City 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
Name
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Mail Addres
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Phone
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Address-
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License No.
Phone
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Lot
Block
Filing Number
Subdivision
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PUD
Parcel If
DESCRIPTION OF WORK
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ICL Mu
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
❑ Ell. ❑ ❑ ❑
Plbg. Mech. 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 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
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Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case it
Date
BBA Case #
Date
Building Insp. Approval
by date
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Permit No.
Date