HomeMy WebLinkAbout630 S Meldrum St - Permits/Reroof - 11/04/1986City of Fort Collins
BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
I Applicant -complete_this part af-form-only"
Press firmly using ball point pen.
Job Address a
Name
`o
c
Mail Address
3
O
Phone fw
0
Name
Address
c
0
U
License No. 3
Phone
n
Lot
Block
Filing Number
y
Subdivision
m
0
PUD
m
Parcel #
DESCRIPTION OF WORK
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.
—Jsigned date
— CLASS -OF WORK. --
New Alte(ati�►� Addition Demolish Move
❑ � ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building Z
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
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
`m
m
2
( )
I )
15
—^�
d
in
`m
r
W
0 O
�i
Street
0
O
72
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
a 72
Permit No.
Date