HomeMy WebLinkAbout1925 Derby Ct - Permits/Single Family New - 05/03/1983City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERM11T AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name RIB REND
c
Mail Address
3
O
Phone 223-5050
0
Name Roger StrnsIlso
m
Address 0 Went HOr etooth
Fort Collins. CO 8052
to
License No. I-12
Phone 223-5050
c
a
Lot 117
Block
Filing Number
h
Subdivision YOU gh
m
PUD
m
J
DESCRIPTION OF WORK
Single Family Dwellinit
Stock Options
Plan No. 01 103 Codes None
Est. Total Cost 2 5 115 00
(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
— CLASS OF WORK —
New ,_- Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
Occ. Gr. Type Const. P/%,
Use Zone
Use of Building _.
Floor Area
Height
No. Stories
Lot Area -
�rontage
Occ. load
Occ. Change from
Plat File No. i ' _ /
No. D.U.
Garage area 4S
Fin. Bsmt. area —�
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning r
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation f� /i j • t
FEES
Permit
Plan Check
St. Oversizing
�l +/ • L�
Water Plant Investment
//t $ a • ��
Sewer Plant Investment
/ 4.S(9 C70
Storm Drainage
• _•''—
Electric Underground
`S 1 Or/
City Sales Tax
Total Fees
Permit No.
Date
0 4 -
MAY 0 'a 1983
p,
a
d
0
ZBA Case # Date
BBA Case # Date
Building Insp. Approval
by date
Off -Street Parking
(No. Cars)
Interior Lot J
Corner Lot ❑
Reversed Corner Lot ❑
a
m
IT
�V
0
c
O
JLL
Street
Distribution: RIginal - Applicant; Blue - Office; Canary - Sales Tax; Pink - Applicant; Tag - Bldg. Insp. -