HomeMy WebLinkAbout2751 W Drake Rd - Permits/Electrical - 04/30/1987City 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 2751 W. Drake Rd.
Name
Mail Address 12680 W.C.R.
3
O
Phone 339-2040
8-
Name Burch Electric Co.
Address
0
Greeley, CO 80631
License No. 29
Phone �03_ 9445
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Lot
Block Filing Number
y
m
Subdivision
PUD
J
DESCRIPTION OF WORK
Electrical connection to phone
cabinet on West Drake Road
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
ordinance an state laws regulating building construction.
=A' UAV�"��
signed Stephen W. re or date
— CLASS OF WORK —
New Alteration Addition Demolish Move
IS ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ IN ❑ ❑
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
35. 00
Parkland
City Sales Tax
Water Plant Investment
Sewer Plant Investment
Storm Drainage
_
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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—^ o m
fn
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c
0
U_
Street
PRMTS 15.00
TOR 15.00
CHCK 1
N99567
12:10 A
APR.30'87
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0
m
ZBA Case #
Date
BBA Case #
Date
Building
Insp.
Approval
by
date
�16 - 7
Permit No.
Date
Distribution Original - Applicant; Blue - Office; Canary - Sales Tax: Pink - Applicant; Tag - Bldg. Insp.