HomeMy WebLinkAbout515 Smith St - Permits - 09/03/1986City 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 Address
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hone 2 ' —7050
Name 4j� i3JeCtftC 111 A",
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Address 1900 tiiaath Parkway
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r'ort 00111 fs, W 30:,:'J4-2723
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License No. ,—]r}j
Phoned-113�
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Lot
Filing Number
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Subdivision
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PUD
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Parcel 1971.;1-19--W1
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 Alte atio Addition Demolish Move
❑ ❑ ❑ ❑
Ibg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Hei �,-
No. Stories /
of L111ea I IFrontage
Occ. load
cc. Change from
Plat File No.
No. D
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department ,� I
Water & Sewer
Plan Review
Special Conditions:
Valuation ` ; f FEES
Plan Check
Permit
'
Parkland
City Sales Tax
IL 77,1 {
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
❑
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d
_IV
d
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by
r/ date
r
t
Permit No.
Date