HomeMy WebLinkAbout1401 Rollingwood Ln - Permits - 05/10/1988City, 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 1401 v
Name
7L�-L'
DR.* MR . P GJ' L
`m
C
Mail Address
o
FT; L.L-1 C . 805 z
Phone 4Q 34 99 J 5
0
Name �'•. + ....
u
A
Address
c
0
U
License No.
Phone
6
Lot
Block
Filing Number
y
Subdivision
N
0
PUD
m
�
Parcel #
DESCRIPTION OF WORK
\/'ELjJK*
Stock Options
Plan No. Codes
Est. Total Cost oo
(including labor, material, profit)
1 hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
drdinances and state laws regulating building construction.
r,
fr
t boa signed "7-N d to
.y
— CLASS OF WORK —
New Alteration 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
1 1
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
T tal. ees
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
v
m
m
d
d
^^
d
d
d
v
in
i m
c
0
�J
Street
0
0
v
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
261o Z
5
It C)
- - Permit No:�
Date
a'•
0
ry PP —. B g.•IrisP.
ffice; Cana Sales Tax; Pink - A IicanF, Te Bltl --