HomeMy WebLinkAbout170 Kensington Dr - Permits/New Commercial - 05/16/1984(.; 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
Name
Mail Add Jess
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Phone 1
Name
Address` 3 f' t'
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License No
Phonef
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Lot
Block
Filing Number
aSubdivision
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PUD
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DESCRIPTION OF WORK
C Q J
6
L
Stock Options
Plan No. Codes
Est. Total Cost .. s
(including labor. material; profit)
I hereby acknowledge that I have read thieapplication and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
signed Z f date
CLASS OF WORK —
'New. Alteration Addition Demolish Move
b-11 ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ,El ❑
Occ. Gr. >. L,d
Type Cons t
Use Zone
Use of Buildings
Floor Area r�
Height r
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 4
Permit
cs, s
Parkland
- -
City Sales Tax'r.'N,
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainages
t __
Electric Underground
Fees
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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Ir
IV
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Street
s
03
ZBA Case # Date
BBA Case # Date
Building Insp. Approval
by date
Permit No.
Date
Distribution: Original - Applicant: Blue - Office: Canary - Sales Tax: Pink - Applicant: Tag - Bldg. Insp.