HomeMy WebLinkAbout825 Coulter St - Permits - 05/07/1984City
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 V. ,--z —' C)" .
Name +
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Mail Address
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Phone
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Name
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Address
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0
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License No.,
Phone
Lot
Block a
Filing Number:
N
Subdivision`- y ,
PUD
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DESCRIPTION OF WORK
Fit
Stock Options
Plan No. Codes
Est. Total Cost° `=
(including labor, material, profit)
I hereby acknowledge that 1 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 (late f
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
PlbMech. Elec. Str❑uc_t Fire❑Prot.
Occ. Gr. P 3
Type Const —
Use Zone
Use of Building $'e/L
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 o,Zc A r A, c7E0
Special Conditions:
fc
Valuation -00 FEES
Plan Check
Permit
Parkland
City Sales Tax
St.Oversizingc�'�LI
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Water Plant Investment
Sewer Plant Investment
Storm Drainage
4, clvz�>
Electric Underground
_
-total Fees
Off -Street Parking
(No. Cars)
Interior Lot
Q
Corner Lot
❑
Reversed Corner Lot ❑
`m
m
65
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0
v� u-
Street
c
0
cc
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by
date
13VY&
Permit No.
Date
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Distribution. Original - Applicant; Blue - Office: Canary - Sales Tax-. Pink - Applicant Tag - Bldg. Insp.