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HomeMy WebLinkAbout1713 Dora St - Permits/Single Family New - 12/03/1986City 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 jig Dore $teeet Name ie Scraee',r w Mail Address 13 : e nVc Phone ate'1—Gzs1'i `o Name u m Address c 0 U License No. I,�1,: Phone 2 n Lot 71 Block Filing Number Subdivision _;j lticl"t1i•1, 4 .,~C;:: ;.. - m ° PUD rn � Parcel # _. 3 � ,;._��__. r DESCRIPTION OF WORK Mood crick 5toe1C Plan Pendirn 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 — CLASS OF WORK — N w Alte Addition Demolish ❑ ❑ Move ❑ Plbg. Mec Elec Struct. P�y Fire Prot. Occ. Gr Type C`o�nst.. Use Zone Use of Building i /c Floor Area Height No. Stories Lot Area Frontage i ? Occ. load Occ. Change from Plat File No. (f1 No. D.U. / Garage area , smt. area / r Type heat / r r I No. Fireplaces or stoves — RELEASES — Dates Zoning f )i� :;t' Engineering Fire Department Electric Department Water & Sewer Plan Review Special Conditions: Valuation ' i FEES 4 Of Plan Check ' Permit Parkland f / " . City Sales Tax St. Oversizing l Water Plant Investment �~ / Sewer Plant Investment Storm Drainage i (' Electric Underground Total Fees Off -Street Parking (No. Cars) Interior Lot 4 Corner Lot ❑ Reversed Corner Lot ❑ 4J } `m d IV Y.) � T � 0 J 1L Street C 0 ZBA Case # Date BBA Case # Date Building Insp. Approval by date 2 4Dt Psrf?r Flo. Distribution. Original - Appl aTbt' Yi9- 08ics. Canary - sales Tax. Rink 'Applicant Tag - Bltlg. Insp.