HomeMy WebLinkAbout412 Maple St - Permits/Reroof - 06/03/1987City 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 14 2
11,
Name,),,Me
rht h
c
Mail Address
3
O
Ili Co
Phone 82 ZZ
0
Name S
Address
c
0
U
License No.
Phone
c
n
Lot I
Block 43
IFiling Number
v
Subdivision
o
rn
PUD
�
Parcel #
DESCRIPTION OF WORK
e- loof- 9
1`a hoa `o
W
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, ateri rofit)
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 regulaun uilding construction.
signed d e
— CLASS OF WORK —
New AlteiVe
❑
Addition Demolish
❑ ❑
Move
❑
Plbg. Mach.
❑ ❑
Elec. Struct.
❑ ❑
Fire Prot.
❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
No. Stories
L
r
r ge
Occ. load
. Change o
Plat File
N D. .
Garage area
in. 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
Total Fees
u -. P,,a. ome - Unnc, canary -sales Tax Pink -A aph cam: Tag -Bldg Ins,
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner
Lot
❑
m
m`
`ID
0
c
0
L
"V
Street
PRMTS
14.50
TAXPM
13.75
TOTL
28.25
`o
CHCR 2 ,
a N20575
09:06 A
> JUN.03'87
ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
date
; C_ ' 00
Permit No.
Date
25