HomeMy WebLinkAbout2190 W Drake Rd - Permits/Demolition - 01/07/1986City 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 Address0kt-
Name Ili C
Mail Address
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Name
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Address Q IV,�� f� :Nk L-scn/G
License No 4&
Phone ygyt • 076 b
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Lot
Block
Filing Number
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Subdivision
PUD
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Parcel #
DESCRIPTION OF WORK
> O fGr �• 014 NCIAl Par ; >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 regu ing building construction.
signed date
umuiounon: ungrnal - Applicant: Blue - Office; Canary - Sales Tax: Pink - Applicant: Tag - Bldg. Insp.
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ' ❑ ❑
Occ. Gr. Fj Z
Type Const. —*"\ Use Zone
Use of Building P t-J ` 1
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:
AqK 3
Valuation FEES
Plan Check
Permit
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Parkland
'
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
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Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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ZBA Case #
Date
BBA Case #
Date
Qsp. Approval
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Permit No.
Date