HomeMy WebLinkAbout125 S Meldrum St - Permits/Addition or Alteration - 12/01/1983City of Fort Coiiins
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
Name v
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Mail Address
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Phone
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Name
Address
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License No..
Phone 22 SS-VO
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01
Lot
Block
Filing Number
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Subdivision
PUD
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DESCRIPTION OF WORK
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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
rdinances and sate laws regulating building construction.
signed' date
— CLASS OF WORK —
New Alte
❑
ion Addition Demolish Move
❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
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
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Overs iz i n g
Water Plant Investment
Sewer Plant Investment
Storm- Drainage-
Electric Underground
Total Fees
Distribution. Original - Applicant: Blue - Office. Canary - Sales Tax. Fink - Applicant Tag - Bldg Insp.
Off -Street
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
a
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Street
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ZBA Case # Date
BBA Case # Date
Building Insp. Approval
by date
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Permit No.
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