HomeMy WebLinkAbout712 Birky Pl - Permits/Reroof - 10/20/1988City 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
Name
`m
c
Mail Address
3
O
Phone OLZ
Name T[
o
U
Address a
in
c
U
License No. Phone 7
Contractor Sales Tax No.
Lot
Block
Filing Number
6
8
d
Subdivision
m
PUD
_01Parcel
# o- — 0-7— QO
DESCRIPTION OF WORK
ZLL
3 0 >
-14pv 4 rrx a
Stock Options
Plan No. Codes
Est. Total Cost r11
(including labor, material, profit)
I hereby acknowledge that I have read this application and
sta the above is correct and agree to comply with all city
o anc s and s ate I s r ulating buil Iing construction.
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signetl da e
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot
❑ ❑ ❑ ❑ ❑
r. Type Co
Use Zone
Building
rea
ENo.Stories
Height
Lot a
Frontagead
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. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m`
2
vlo
y
( 1 ( 1
d
n
m
c
0
"J LL
Street
PRMTS 25.00
TAXPM 20.55
TOTL 45.55
CHCK 4.
N24203 07=24 A
s
OCT.20W
v
ZBA Case # Date
BBA Case # Date
Building Insp. r 1 Approval
by
Ld date
r
Permit No.
Date
.55
Distribution'. Original - ApplicanC Blue - Office: Canary - Sales Tax: -Pink - Applicant, Tag - Bldg. Insp.