HomeMy WebLinkAbout309 W Mountain Ave - Permits - 07/03/1986City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERhOT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 30
NameI, _
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Mail Address
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Phone
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Name
Address
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License No. S b5
Phone �Z
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Lot Block
Filing Number
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Subdivision
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PUD
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Parcel #
DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
Est. Total Cost
(including labor• material, profit)
I hereby acknowledge that I have read this application and
sta'e that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
signed date
•- .�„y�,�ei - .Tpncan r. mue - Uttmel Can - sales Tax: Pink -Applicant; Tag - tllog. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
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Corner Lot
❑
Reversed Corner Lot
❑
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RECEIVED
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BY
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
184
L. Permit No.
Date