HomeMy WebLinkAbout1136 E Stuart St - Permits - 12/20/1984City of Port 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
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c
Mail Address
3
.O
Phone
Name
o
Address
0
0
U
License No.
Phone
4
a
Lot
Block
Filing Number
H
Subdivision
°
PUD
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J
DESCRIPTION OF WORK
Stock 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
ordinances and state laws regulating building construction
--- —
,signed- .- - date -
— CLASS OF WORK
New Alteration Addition Demolish Move
42 ❑ ❑ ❑ ❑
Plbg. Mech. Else. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. -
Type Consti ; _ _)
_
Use Zone
Use of Building
FloorArea I! _ �—
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:
J J 1 c U 1
II c I.0 - r %-%10 AkOT .� 5
9__Z- R6
V'aluation FEES
Plan Check
Permit
Parkland
-
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
lnI tribution. Original - Applicant, Blue - (Mlice, Canary - Sales Tax. Pink Applicant. Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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ILL
Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Q(/
Permit No.
Date