HomeMy WebLinkAbout170 Kensington Dr - Permits/New Commercial - 06/29/1984 (4)....'w' .ism'¢ :5.�,� Y,,.,
City of Fort Collins BUILDING INSPECTIONsDIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 1Q , S'
Name C' 1 Q�_At T y 1 t Nv.. cf-1 ;. ff€'.`J Ell
Mail Address ``/ r
d.t i 4 P< Phone`
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Name
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Address t.`'ff • `}}t3'{ Ir+ L. 1}`:
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License No. f' r
PhonetY-
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Lot ,e-
Block
Filing Number
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Subdivisloh + v t
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DESCRIPTION OF WORK
4 D"I tJ6,
i
Stock Options
Plan No. _ Codes
Est. Total Cost
(including labor, material, profit)
hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinance ,' nd state laws regulating building construction.
signed„� "`dale r`�`
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— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ O�. ❑
Occ. Gr. f�' &:
Type Const. Use Zone
Use of Building j
Floor Area -rj2 " . }
Height K_, j
No. Stories
Lot Area rr}s r ,n Frontage r t�',x r
Occ. load
Occ. Change from
Plat File No.' " i4 f
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 , ,),F:_ �'� A,;' ;/ 'tt rJ
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
f
Off -Street Parking'
(No. Cars)
Interior Lot
❑
t
Corner Lot
st
Reversed Corner Lot ❑ -.
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IV
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Street s` 5 r .
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ZBA Case #
Date
BBA Case #
Date
Building Insp. 9 Approval
by
date r
(7LO
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Permit N0" 1�-
Date
Distributiori': Original - Applicant561ue—�btfice; Canary -Sales Tax; Pink -Applicant; Tag - BfdI Insp.