HomeMy WebLinkAbout5751 Ballina Ct - Permits/Single Family New - 12/19/1984City 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_.
Mail Address
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Phone
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Name
Address
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License No.
4
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N
Lot Block Filing Number
Subdivision
o
PUD
d
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DESCRIPTION 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 '"� ` ,� � •�_datet+'t•
— CLASS OF WORK —
New Alteration Addition Demolish. Move
O— ❑ ❑ ❑ ElPlbg.
Mech. Elec. Struct. Fire Prot,
El ❑ ❑ ElOcc.
Gr. Type Cons,.
Use Zone
Use of Building
Floor Area
Height d
No. Stories
Lot Area
Frontage
Occ. load
Occ. Change from
Plat File No. r i /
No. D.U.
Garage area
Fin. Bsmt. area r
Type heat 7
No. Fireplaces or stoves
— RELEASES — Dates
Zoning f /t.• i ,f .: .1'.
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review.
Special Conditions:
Valuation FEES
Plan Check
L4 t7
Permit
Parkland
City Sales Tax
'�lC'Si1 r
St. Oversizing
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Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
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7raEal Fees`
DisViburgn Original - NpplrC—aN.aPie's'Office.'Canery-Sales -Tai Fmk'I-Ppphc.w Tag - Ba Insp%
Oft -Street Parking
(No. Cars)
Interior Lot
O
Corner Lot
❑
Reversed Corner Lot ❑
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4 p
Street "- .:
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by n date
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Date