HomeMy WebLinkAbout1524 Sam Houston Cir - Permits/Single Family New - 03/14/1986City of Fort Collins BUILDING INSPECTION D,IVIS101s
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name D. C' o BuMs E:ormt3c�Ct.Om Co.
Mail Address 1106. Ye" N)*]geg
Q
Lovol p CO. 8053p
Phone
Name Da E. Bu$°&3£3 Ct3nk3tsmation Co.
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Address 9106 YOW P.b1Cts
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Loveland, OoaQ a 37
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License No. D _ �
Phone 6&>-8386
a
Lot
Block
Filing Number,
N
Subdivision•
ro
PUD
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I
DESCRIPTION OF WORK
Stele 1paffdly Res.
Stock qff 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
ordina ces and state laws regulating building construction.
tJ Q
signed \dat`e
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— CLASS OF WORK —
Noty. Alteration Addition.. Demolish Move
OX ❑ ❑ ❑ ❑
P�bg: Mepp. Elec Struc . Fire Prot.
C Ex ❑
Occ. Gr.A-al
Type Const. 4-V
I Use Zone .�
Use of Building
FloorArea it
Height
No. Stories,/
Lot Area
Frontage
Occ. load
Occ. Change from --^-----"
Plat File No. ""�
No. D.U.
Garage area :,�
F' sm "ar a�
Type heat
No Fireplaces or � oves
— RELEASES — Dates
Zoning `7� '' ,�/a ✓'
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review`'`'
Special Conditions:
Valuation �G'' FEES
Plan Checks
Permit
1i
Parkland
City Sales Tax
f?.
St. Oversizing
Water Plant Investments
J�
Sewer Plant Investment
_ 1
Storm Drainage
'
Electric Underground
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_
TotalF_ees, c-,
Distribution: Original-rApp'fican Qlue - C ffice,,`yary - Sales -TA'. Pink' -�Appiicaot:� h Bldg. Ins
Fti-
//77 1_ (e521
Off -Street Parking
(No. Cars)
Interior Lot 3IF
Corner Lot O
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Reversed Corner Lot ❑
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Street
MAR. 14'96
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ZBA
Case # Date
BBA
Case # Date
Building Insp. Approval
by
f date
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