HomeMy WebLinkAbout1200 W Myrtle St - Permits/Reroof - 09/16/1987City 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 ,rS+
Name
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Mail Address �(
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Phone
Name
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Address
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92
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License No.
Phone d
Contractor Sales Tax No.
4
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Lot
Block
Filing Number
N
Subdivision
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PUD
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Parcel #
DESCRIPTION OF WORK
.ti
Stock Options
Plan No.
,C)odes
v
Est. Total Cost
(including labor, ma enal, profit)
I hereby acknowledge that I have read this application and
state that the above i� correct and agree to comply with all city
ordinances and S. a laws egulating building construction.
signed' da
— CLASS OF WORK
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
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:`
Valuation FEES
Plan Check
Permit
. S
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
_
Electric Underground
--yl
Total Fees I
islribulion: Original - Applicant: Blue - Office: Canary - Sales Tax: Pink - Applicant. Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner
Lot ❑
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PRMTS 20.50
TAXPM 16.50
Street
T$TT1L37-.
89
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N23483
19:29 A
SEP.07'87
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ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
d ate
Fz-7Cc:;o'(5
9/In)e7
Permit No.
Date