HomeMy WebLinkAbout1703 W Mulberry St - Permits/Addition or Alteration - 01/09/1989City 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 ( W . V L e>=Q2
Name t�leLie y�i iCC
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Mail Address I 6 �� rfrl
Phone
Name
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Address \� n7
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License No. �_ _ �.� Phone ' y� -�,�c( '4
Contractor Sales Tax No.
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Lot
Block
Filing Number
Subdivision
PUD
Parcel #
DESCRIPTION OF WORK
rc
Stock Options
Plan No. — __ Codes
l ta6c> C TS„cc)
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
ordinances and state laws regulating building construction.
-K date
signed
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elea Struct. Fire Prot.
❑ ❑ ❑ __ ❑ ❑
Occ. Gr. Type C,onst. _ Us e
Use of Building
Floor Area r )'YL,'" Height
No. Stories Lot O ai Frontage
Dec. load a 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 CheckZD I
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
_
Storm Drainage
Electric Underground
Total Fees
D isinbu0on Ongmal AP Cant Blue - Office. Canary -Sales Tax Pmk - ADpl cant. Tag - BICq Insp-
Oft -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
m
Ir
( 1
f 1
C
0
Jli
Street
0
ZBA Case #
Date
-
BBA Case #
Date
Building Insp. �.L, Approval
by i'' / date
e 9oos�
l l 9 /8 9
Permit No.
Date