HomeMy WebLinkAbout1756 Somerville Dr - Permits - 05/20/1986City 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
It
m Mail Address
c
3
O
Phone '
Name
0
Address
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License No. Phone
n2 Lot Block Filing Number
Subdivision
o
m
PUD
rn
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. — Codes t =
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.
- signeddate
— CLASS OF WORK
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg.. Mach. Elec.' Struct. Fire Prot.
❑1. ❑ ❑ ❑
Occ. Gr, Type Const. Use Zone
Use of Building
;EArea Height
tories Lot Area
Frontage
Occ. load Occ. Change from
No.
. D.U.
EGaragereaElqFir
heat
Bsmt, areaType
. Fireplaces W stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:/
Valuation FEES
Plan Check
Permit r'
Parkland
City Sales Tax
j
St. Oversizing
Water Plant Investment
Sewer Plant Investment
,
Storm Drainage El _
ectric Underground
Total Fees
Distribution: Original - Applicant; Blue - Office,'Canary Sales Tax, Pink - Applicant, Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
Cl
Reversed Corner Lot
❑
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a
id
A
d
cc
m U)
c
0
tL
Street
C
O
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Permit No.
Da e