HomeMy WebLinkAbout2555 S Shields St - Permits - 09/08/1986 (2)City of Fort CollinS BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERAAIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
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Mail Address
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Phone
Name �I1Dr iQn1G F
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Address
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License No.
Phone
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Lot Block
Filing Number
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Subdivision
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PUD
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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
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ C}
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
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
❑
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SEP 91986
Poudre Fire Authority
BY
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
212
Permit No.
Date