HomeMy WebLinkAbout1430 Glen Haven Dr - Permits/Addition or Alteration - 08/02/1984City 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
Name g t,
Mail Address
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Phone
Name -- `, c. _ II
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Address
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License No. - "r-, �/ Phone
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Lot
Block
Filing Number
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Subdivision
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DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, p(ofit)
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.
signed date
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
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
Permit
Plan Check
--- - -
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
-- --
Electric Underground
- -
City Sales Tax
Total Fees
Permit No.
Date
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ZBA Case # Date
BBA Case # Date
Building Insp. Approval
by date
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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Distribution: Original - Applicant; Blue - Office; Canary - Sales Tax, Pink - Applicant; Tag - Bldg. Insp.