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HomeMy WebLinkAbout2943 Southmoor Dr - Permits - 10/14/1986City 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 Address /1 Name c Mail Address V Phone Name '" !1 0 m Address: c o F 4 License No. i 7' ;1 Phone- 2°- a Lot Block Filing Number y Subdivision m PUD rn °; Parcel # DESCRIPTION OF WORK a y ' E t d; r Stock Options Plan No. Codes Est. Total Cost i (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 lawyiegulating building construction. —. -tom signed X date — CLASS OF WORK — New Alteration .-Addition Demolish Move ❑ CrI ❑ ❑ ❑ Plbg. Mech. Elec. Struct. Fire Prot. ❑ ❑ ❑ ❑ ❑ Dec. Gr. Type Const. Use Zone Use of Building Floor Area Height No. Stories Lot 4rea Frontage Occ. load Occ: Chang fro(h . t - t Fi e PI Garage ar_ a' Fin. Asmt. area Type heat No. Fireplaces or stoves — RELEASES — Dates Zoning Engineering Fire Department Electric Department Water & Sewer Plan Review Special Conditions: r Valuation �'; `---- FEES Plan Check Permit TZi.. Parkland City Sales Tax St. Oversizing Water Plant Investment Sewer Plant Investment Storm Drainage Electric Underground al ees\ c_ Distribution: Original - Applicant: Blue - 04tice: Canary - Sales Tax, Pink - Applicant, Tag - Bldg. 146p. Off -Street Parking (No. Cars) Interior Lot ❑ Corner Lot ❑ Reversed Corner Lot ❑ a Ed d _IV d (D �^ d a d to Y io c 0 ti "J Street 0 0 a ZBA Case # Date BBA Case If Date Building Insp. / f-Approval by date Permit No. Date J