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HomeMy WebLinkAbout5763 Ballina Ct - Permits/Single Family New - 09/24/1984City of Fort Collins BUILDING INSPECTION DIVISION APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Ap hcan complete This part of form only, Pr i jin' A oint 'F Job Address t Name `m c Mail Address ^ej 3 O Phone 0 Name U Address 0 O License No. Phone c a Lot Filing Number/ `o —BIock _ Subdivision 0 N PUD v J DESCRIPTION OF WORK Nor IFOz- L-f e F Stock Options Plan No.—� Codes Est. TotalI Cost y`' �i� Q�k OG (including labor, material{proht) 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. .-_rid Y, — CLASS OF WORK — e Alteration Addition Demolish Move Cl ❑ ❑ ❑ Plbg. Mech. Else. Struct. Fire Prot. ❑ ❑ El ❑ ❑ Occ. Gr, Type Const.It Use Zone Use of Building Floor Area q4D rIlHeight ! Sj�No',Stories .Lot Area Frontage Occ. load Dec. Change from Plat File No. Ll fT­1 No. D.U. Garage area .qC>O Fin. Bsmt. area —B— Type heat C, r-A No. Fireplaces or stoves — RELEASES — Dates Zoning � ' / P.J y . Ov . y Engineering Fire Department .. Electric Department Water & Sewer Plan Review Special Conditions: �+ Valuation 4. 1` FEES Plan Check Jj C,i 1 Permit, Parkland G ��- •?..) City Sales Tax �;'} St. Oversizing L�1 j ljy7 Water Plant Investment -� _ Sewer Plant Investment Storm Drainage Electric Underground Tothl Fees oe Off -Street Parking oC (No. Cars) Interior Lot O Corner Lot ❑ Reversed Corner Lot ❑ D r m` d v 1 m M � c 0 LL �J Street 61_1 A 1l �M MTS ^54-47 PKFEE 590.00 IAAFM 36'Z_ lt)U ,TOVR 2V G� TTO"L 4 y, c 0 a a ZBA Case # Date BBA.Case k Date Buildin In��pp Approval by &.. date Y Date p i¢mi�ntiinginal-A�phMntp e-Okrce:'Canary-Sa11Tai'PlIk+Appllicanr Tag- Bldg.lnsp.