HomeMy WebLinkAbout525 Breakwater Dr - Permits/Footing and Foundation - 08/23/1989City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Appli a Iete this part of form only,
sr0t3iy using ball point pen.
Job Address
Name Flak
m
Mail Address
c
3
O
Phone
Name
a
8
Address
m
c
0
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License No. Phone
Contractor Sales Tax No.
G
°
Lot Block Filing Number
n
m
Subdivision
m
PUD
m
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Parcel q
DESCRIPTION OF WORK
Sr-c
n
D�
Stock Options
Plan No. Codes
�7
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 date
Distribution: Original - ApplrcariL Blue - Office, Canary -Sales Tax.,Pink - Apphi
- CLASS OF WORK -
New
Cl
Alteration Addition Demolish
❑ ❑ ❑
Move
❑
Pibg.
❑
Mech. Elec. StrucL
❑ ❑ ❑
Fire Prot.
❑
Occ. Gr.
Type Const.
Use Zone
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑