HomeMy WebLinkAbout1604 Independence Rd - Permits/Reroof - 10/22/1979CITY OF FORT COLLINS
APPLICATION FOR BUILDING PERMIT —SHORT FORM
Building Address
Date of Application fl — Z
10
Name
3
Mail Address
O
City �l�.. , el. No.
o
Name
t
Address
City
O
O
City License No.L - ysj Tel. No.
Occupancy Group A, B, C, D, E, F, G,
H, I, J Division 1, 2, 3, 4
Use Zone —RE, RL, RLM, RM, RH, RP, RMP
ML, MM, BP, BL, HB, BG, C, IL, IG
Fire Zone 1, 2, 3
PUD
Class of Work
Plumbing
_Roofing
Heating .—Fencing
_
Electric
_Sprink. —
Gas Pipe
_Storm W—
Sign
_Other _
Total Value Labor & Mat.
/3aa . �-v
Description of Work
r
_"
Permit No.
7
3
VALUE
Date issued
Bldg. fee
Other
Total
Int. lot
Corner lot
Rev. C. L.
Street
Approved for Chief B.I.
Zoning
Signature of owner _
By Contractor y s ��1 %� B•i