HomeMy WebLinkAbout1234 W Prospect Rd - Permits/Plumbing - 11/29/1984City
of Fort ColllnS 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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Mail Address
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Phone
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Name �P A C-/'
Address
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License No. /�i j j�
[phone
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Lot Block Filing Number
Subdivision
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DESCRIPTION OF WORK
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Stock Options
Plan No. - ----- Codes —
Est. total Cost -—
imcluding 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
❑ ❑ ❑ ❑ ❑
PIbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. IType
Const. jUse 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 R Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit -
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
_ -
D stnhunon Orignial - Applicant. Blue - office Canary Sales Tax Pin6 - Appbcant Tag - Bldg Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
iSs 3S
//-D9-5y
Date
Permit No.