HomeMy WebLinkAbout642 S Meldrum St - Permits/Reroof - 03/11/1987City 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 q 2S V
Name thus
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Mail Address
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Phone 2Z _ 61
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License No. if
Phone
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Lot ',Block
Filing Number
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Subdivision
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Parcel #
DESCRIPTION OF WORK
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Stock Options
Plan No. Codes -
or.
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.
ned date
— Cl_S OF WORK -
- New AltelratiqK Addition- Demolish- Move-
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Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building r
Floor Area
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No. Stories ^
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Occ. load
CC. ng r
Plat File
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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:
Art
Valuation FEES
Plan Check
Permit {
Parkland 1�
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.
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Off -Street Parking
(No. Cars)
Interior Lot
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Corner Lot
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Reversed Corner Lot ❑
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Street
PRMTS 17.50
TOIL 17.50
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> MAR.12'87
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
date
by date
Permit No.
Date
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