HomeMy WebLinkAbout3737 Benthaven St - Permits/Addition or Alteration - 03/10/1986City _ Fort Collins BUILDING INSPE N DIVISION
APPL ATION FOR BUILDING PERMIT AND CERTIFICATE OF O UPANCY
+ Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name
Mail Address ? 07
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Phone i?
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Name
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Address �y_l
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License No.
Phone
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Lot
Filing Number
-Block
Subdivision
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PUD
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DESCRIPTION OF WORK
14 _ 01i o S
C �r
Stock Options
Plan No. -,�, ,, Codes
I) Est. Total Cost ! o �
(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.
-- i/Sill gned ` date
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— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑` ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
FlooyArea
Height
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
� 3 1ZI�
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
V
Permit
Parkland
City Sales Tax
�—
St. Oversizing
_
Water Plant Investment
Sewer Plant Investment
Storm -Drainage
Electric Underground
Total Fees
y
0is[nbution Original CApppdint,'Blue- Oiti / 6' ary -Sales Tax. Pink -A aph cant: Tag - Bldg Insp.
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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Street
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MAR 1 3 1986
Poudre FireAuthority
BY
ZBA Case # Date
BBA
Case # Date
Building Insp. Approval
by;
date
114
Permit No.
Date