HomeMy WebLinkAbout201 E Mountain Ave - Permits - 04/16/1984City 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 O MTIJ
Name
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Mail Address
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Phone
Name N
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License No.
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Lot
Block
Filing Number
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Subdivision
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,PUD
DESCRIPTION OF WORK
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Stock Options
Klan No. Codes
Est. Total Cost
jineluding labor. material, profit)
• 1 hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordi,+antes and state laws regulating building construction.
signed date
— CLASS OF WORK —
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N Alteration Additionmolish Move
❑ ❑ ❑ ❑
P Mecq Elec. _ truct. Fire Prot.
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Occ. Gr.
Type Con se Zone;
Use of Building K t y� ,Cot
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:
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L, ® I.:t) ,,
Valuation FEES/
Plan Check
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Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
_
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Dist nbuion Ongii — Appli�n0Bl�u .P lick Canary - Sales Tax. Pink - Applicant. Tag - Bldg. Insp.
16
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Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by/ date
Permit No.
Date `