HomeMy WebLinkAbout921 W Mountain Ave - Permits - 11/19/1984City 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
TName
ail Address -
Phone
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Name L
Address
c
o
—
U
License No.
_
phone
c
Lot
Block
—
Filing Number
N
Subdivision
Subdivision
m
PUD
J
DESCRIPTION OF WORK
Stock Options
Plan No. Codes, ---
Est. Total Cos{-
(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 -afl-eily
ordinances and state laws regulating building construction.
signed date
— CLASS OF WORK
New Alteration Additi Demolish Move
❑ ❑ Q ❑ ❑
Plbg. Mach. Elea, Struct. Fire Prot.
❑ ❑ El❑
Occ. Gr. t,� <) Type Const. ., ;11 Use Zone
Use of Building
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 R 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 Fqes
Dufnbubon Original - Applicant Blue - Office. Canary - Sales Tax 11 nk - Applicant Tag Bldg Insp
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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m
az
cz
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m
m
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0
LL
Street
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ZBA-Case f
Date
BBA Case #
Date
Building Insp. "' Approval
by date
Permit No.
Date