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of Collins
BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Ott -Street Parking
Applicant complete this part of form only.
-- CLASS OF WORK —
(No. Cars)
Press firmly using bait point pen.
New Alt ration Addition Demolish Move
Interior Lot
❑
.fob Address
❑ ❑ ❑ ❑
Corner Lot
❑
Name
Plbg. Mech. Elec. Struct. Fire Prot.
{ ❑ ❑ ❑
Reversed Corner Lot
❑
i ..,
Mail Address Address
Occ. Gr.
Type Const.
Ube Zone
r
e.
Use of Building
FloorAraN"" _
� g
cr
Phone d.
Name -
a
No. Stag
'ot�Are �`
Frontage
Addr '
7
Occ. Toad
Occ. Change f r rrl . ,.
Plat File No.
Nd. -U-
a:
License No We
Garage area
Fin. Bsmt, area
Lot Block Filing Humbert
Type heat
No. Fireplaces or stoves
b
bill i '
— RELEASES — Dates
ro
e
Cr
u v sion
PUD
Zoning
Engineering
U.
Parcel N
DESCRIPTION OF WORK
Fire Department
a: s'
Electric Department
Street
Water & Sewer
Plan Review
`
Special Conditions:
0
�r
7 $34" F-
Valuation.. g.
FEES
Plan Check
stock Options
Permit
- . .
Finn No. Codes -
Parkland
,�„
Est. totem mat'
City Sales Taxi'
ZB C f1
bate
(Including Tabor; materfil, pro#it
'
St. Oversiziva
'
-• r�
v
t scktwwledge .that f h*V* re+sd tFiis application and, Water Plant Investment
s above Is corr ®ct I tb dothply with all city Sewer Piant investment
and state laws dating bulming construction. storm Drainil
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