HomeMy WebLinkAbout1104 Green St - Permits/Reroof - 10/16/1986City 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 i
Name B t
Mail Address
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Phone
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Name r . '' a
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Address77
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License No.
Phone,' " �y
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Lot
Block
Filing Number
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Subdivision
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PUD
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Parcel #
D CRIPTION OF WORK
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 ate r
— CLASp OF WORK —
New Alteratio Addition Demolish Move
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height J
No. Stories
Lot Area ib
Frontage
Occ. load
Occ. hange from
Plat File Nq.
No.,D.U.
Garage area
Fyn. 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
T tal Fees
Distribution: Original - Applicant; Blue - Office; C�nary' Sales Tax: Pirik - Applicant; Tag - Bldg I 'Insp.
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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ZBA Case # Date
BBA Case # Date
Building Insp. Approval
by date
Permit No.
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