HomeMy WebLinkAbout819 Coulter St - Permits - 05/07/1984 (2)City of Fort CollinS BUILDING INSPECTION DIVISION _ T
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address ` 1cl
Name CO-Fic T—
Mail Address >*, A
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Phone
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Name
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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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DESCRIPTION OF WORK
P` e
IPl9
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.
-date
signed - -
Uistribut,on Original - Applicant: Blue - Office; Canary - Sales Tax. Pink - Applicant. Tag - Bldg. Insp.
— CLASS OF WORK —
New Alteration Addition Demolish Move
13-1. ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. 1-3
Type Const. —7. A)
I Use Zone
Use of Building s�2
FloorArea
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No. Stories
Lot Area _Z3a,e_
Frontage,_
Occ. load
Occ. Change from
Plat File No. s �' f
No. D.U.
Garage area
Fin. Bsmt. area �Y a
Type heat,,-, �, = , ti
No. Fireplaces or stoves
— RELEASES — Dates
Zoning / ;
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review p Ic Ir S e! C i GrO s104V E'L 0
Special Conditions:
Valuation p?lU FEES
Plan Check 5-
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
,59~#
Sewer Plant Investment
--�
Storm Drainage
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot
a -
Corner Lot
❑
Reversed Corner Lot ❑
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ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
date
Permit No. ,',
Date