HomeMy WebLinkAbout2554 Midpoint Dr - Permits - 06/14/1983City 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
Name f
r
ro
c
Mail Address
3
O
Phone
Name
0-
Address
0
U
License No. _.,a+r
hone r
c
2
Lot -
Block
Filing Number
n
Subdivision
0
m
PUD
m
m
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
❑ ❑ ❑ ❑
P g. Mech. Elec. Struct. Fire Prot.
a a,_ ❑. ❑ ❑
Occ. Gr. 1 '"-{
Type Const. ` -
Use Zone
Use of Building y ,
Floor Area
Height
No. Stories l
Lot Area -
Frontage .
Occ. load
Occ. Change from
Plat File No.
No. D.U.
Garage area
Fin. Bsmt. area -'
Type heat r3 " /"{
No. Fireplaces or stoves
- RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & 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
Distribution: Original - Applicc❑T, Blue - Office. C.inary - Sales Tax', Pink - Applicant Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m
m
l I 1
d
C
}
rn
0
LL
Street
c
O
6
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ZBA Case # Date
BBA Case # Date
Building
Insp. Approval
by
date
"
10834
Permit No.
Date
8