HomeMy WebLinkAbout3106 Sam Houston Cir - Permits/Patio Cover or Sunshade - 02/18/1987City 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 en.
Job Address
Name tart - , Fr e e
Mail Address
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Phone _ 70
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Name �OYI�E S i P P'
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Address
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License No.
Phone
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Lot
Block /
Filing Number
N
Subdivision
0
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PUD
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Parcelrt#k'�
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V
DESCRIPTION OF WORK
tn.
Stock Options
Plan No. Cod
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
ordinances and state laws regulating building construction.
sign date
— CLASS OF WORK -
New Alteration Ad Itio Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec. Str-uct.,4o, Fire Prot.
❑ ❑ ❑ lC]-10 ❑
Occ. Gr. R_ �
Type Const.' -'
Use Zone 12LIO
Use of Building
FloorArea
Height
No. Stories
Lot Area
Fr t ge
Occ. load
Occ Chi f o
Plat File A.
U.
Garag ea - Ilin.
s . area
Type heat
No. Fireplaces or stoves.
RELEASEE�S,, — Dates
,-
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review L IW L �Z
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
Oversizing
-St.
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m
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Street
PRMTS 23a50
TAXPM 19.25
o TOTL 42.75
ro CHC1. 4•
N27226 23946 A
FEB.19'87
ZBA Case # Date
BBACase# Date '
Building Insp. Approval."
by date }
Permit No.
Date
.75
tribution: Original - Applicant: Blue - Office: Canary - Sales Tax: Pink - Applicant; Tag - Bldg. Insp.