HomeMy WebLinkAbout209 Dartmouth Trl - Permits/Reroof - 10/14/1986malty of Fort C olhnS 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 a
Name
c
Mail Address
3
O
Phone
Name
o
m
Address
c
0
U
License No.
Phone
C
2
Lot
Block
Filing Number
Subdivision
m
PUD
m
Parcel #
DESCRIPTION OF WORK
i
Stock Options
Plan No. Codes
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.
signed date,,
- CLAS, OF WORK -
New Alteration.' Addition Demolish Move
❑ -% ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Hight
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
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Tot I Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
`m
m
Cc
Cc
V
0
0
..J
Street
ui
c
0
a
ZBA Case # Date
BBA Case # Date
Building
Insp. Approval
by
date
Permit No.
i Date
Distribution. Original - Applicants, Blue - Office', Canary - Sales Tax. Pink - Applicant. Tag - Bldg. Irfsp. i