HomeMy WebLinkAbout116 Rutgers Ave - Permits - 10/16/1986City of Fart Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERWT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firm'y using ball point pen.
Job Address
Name )
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Mail Address
3
O
Phone
Name
o
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Address �p
U
License No.
Phone
c
2
Lot
Block
Filing Number
Subdivision
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m
PUD T
m
Parcel #
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
❑ [a ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Dec. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Dec. it
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:
3
a
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
�--
St. Oversizing_
Water Plant Investment
Sewer Plant Investment
Storm Drainage_
Electric 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
❑
Reversed Corner Lot
❑
`m
m
m
Ir
( )
( I
d
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to
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0
0
LL
Street
C
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6
72
ro
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by datef
5 7
/ 6196
Permit No.
Da e