HomeMy WebLinkAbout212 Dartmouth Trl - Permits/Reroof - 03/31/1987City 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 x I Z r
Name Ko Tl G
c
Mail Address
3
O
Phone
a
Name,
Y
Address
0
0
U
License No,.Y- Phone G
0
°
Lot
Block
Filing Number
Subdivision
m
PUD
rn
Parcel it
DESCRIPTION OF WORK
OFF r
'VereL-r P lee /1 r/
T
Z
Stock Options
Plan No. _ Codes
Est. Total Cost
(including labor, aterlal, profit)
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordin s s laws regulating building construction.
-- signed -- ,_- `date --�
— CLASS OF WORK
New Alt ,�e n Addition Demolish
CI❑ ❑
Move
❑
Plbg. Mech. Elec. Struct.
❑ ❑ ❑ ❑
Fire Prot.
❑
Occ. Gr.
Type Const.
Use Zone
Use of Building a25
Floor Area
Heig
No. Stories
Lot Area
ont
Occ. load
c r m
Plat He N .
Garage area . Bsmt. area
Type heat No. Fireplaces or stoves
— RELEASES —
Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
i
Plan Review
Special Conditions:
QU
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
— — Y—P - .+yynLaniowe vinme. canary - Sales Tax'. P'mk - Applicant, Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner
Lot ❑
m
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ac
Cc
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Street
PRMTS 22.00
TAXPM 17.60
TOTL 39.60
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CHCK 3 ,
a N98531 16:46 A
MAR.31'87
ZBA Case #
Date
BBA Case #
Date
Building Insp.
proval
by
date
/
�7
Permit No.
to
60