HomeMy WebLinkAbout2643 Shadow Ct - Permits/Reroof - 11/25/1986City of Fort CollinS BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERhUT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address G
Name L
`m
C
Mail Address
3
O
Phone ZZ 3
Name
m
Address L
o
U
License No.
Phone
2
a
Lot
Block
Filing Number
Subdivision
d
M
PUD
Parcel #
DESCRIPTION OF WORK
r
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
❑
ech. Plbg. MElec. Struct.
❑ ❑ ❑ ❑
Fire Prot.
❑
Occ. Gr. Type Const.
U e Zo
Use of Building
Floor Area e' ht
No. Stories
L Ar
Fro e
Occ. load
O c. ange fro
Plat File
. D.
Garage area
n 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
Distribution Original - Applicant', Blue - Office', Canary - Sales Tax'. Pink - Applicanf. Tag - Bldg. Insp. f
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
m
`a
a)
Cc
o
�
d
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U
c
O
�JLL
Street
c
0
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
6�A
/
/—
Permit No.
Date