HomeMy WebLinkAbout629 W Mountain Ave - Permits - 02/17/1987City 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 4 w a l
Name b0filla ' Yt k,
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Mail Address !�% Vc
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1-0s -101
Phone �21 3 77+,
Name J�/>1h/V/ ;1 4vn1
Address c t �7
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• V�'�It+1S .5 _�'L
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License No. .5 - 7 3 _ i Phone t{ -(: `PLC)
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a
Lot
iBlock Filing Number
Subdivision
°
A
PUD
Parcel #
DESCRIPTION OF WORK
'saui;< ISIs,,
---
Stock Options
Plan No. ____- Codes -
2 3
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 ion Addition Demolish Move
❑ ❑ ❑ ❑
_
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr,
Type Const.
Use Zone
Use of Building
Floor Area
J.Hei
No. Stories
L ea
to e
Occ. load
O c. Ch om
Plat File N //
. D.
Garage area
F . B area
Type heat
o. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department___
Electric Department
Water & Sewer
Plan Review
Special Conditions:
'177
i
Valuation /4 FEES
Plan Check
Permit
Parkland
City Sales Tax
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.
I
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
PRMT5
38.50
TOT!
38.50
CHCK 3
a N97159 04=16 A
a FEB.17'87
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
bydate
Z / &�
1
Permit No.
Date
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