HomeMy WebLinkAbout512 E Myrtle St - Permits/Reroof - 04/20/1987City 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
c
Mail Address
3
O
TT
hone
Name ' Ltil f
o
Address Pm SD
Ef
0
U
License No.;5 —
Phone
°
n
Lot
Block
Filing Number
N
Subdivision
m
°
PUD
Parcel #
DESCRIPTION OF WORK
S 4
v
Stock Options
Plan No. Codes
417
Est. Total Cost
(including labor, Material, profit)
I hereby acknowledge that I have read this application and
slate that the above is correct and agree to comply with all city
or and st e I ws/Jre�gu ling b Ilding cons ru%ctl n.
signed dal
- CL
SS OF WORK -
New Altera
❑
Addition Demolish
❑ ❑
Move
❑
Plbg. Mach.
❑ ❑
Elec. Struct.
❑ ❑
Fire Prot.
❑
Occ. Gr.
Type
Const.
Use
Use of Building
Floor Area
He h
No.
No. Stories
of
r
F
Occ. load
Oc
Ch e ro
File
1D
ir
Garage area
. 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
_
l ze
Parkland
r
City Sales Tax
r
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
_
Electric Underground
Total Fees
Distribution Original - Applicant: Blue - Office: Canary - Sales Tax. Pink - Applicant Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
m
�v
c )
t )
to
`m
r
to
c
0
Street
PRMTB 28.00
TOTL 28.00
CHCK `'
N29309 17:35 A
APR.22'87
0
ZBA Case #
Date
BBA Case #
Date
Building Insp. j Approval
by date
Permit No.
Date
.00