HomeMy WebLinkAbout611 W Mountain Ave - Permits/Plumbing - 02/27/1985City 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 Ilk;A
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Mail Address - --
Phone
Name
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o
Address
C
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License No. PhoneZZ �:
4
Lot y Block Filing Number
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! Subdivision
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PUD
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3 - 3 �o
DESCRIPTION OF WORK
3 t
I77
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
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ IX ❑ ❑ ❑
Plb Mec. Elea. Struct. Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr.
Type Const. Use Zone
Use of Building f
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
D,slnbuhon Ongmal-App6carn Blue - Office .Canary - Sale, Ta.P4 Applicanl Tag - Bldgfnsp '
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. _ Approval
by
date
s
aa-
Permit No.
Date