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HomeMy WebLinkAbout3106 Sam Houston Cir - Permits/Addition or Alteration - 09/15/1986City O Fort Collins BUILDING INSPECTION DtYIS.!ON APPLICATION .FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Applicant complete this part of form only. Press firmly using ball point pen. Job Address ".7 f V t. 1/011 - /-,%-. W r Name • •BOW C08 5,t&,q $'A.• Mail Address f o alwtg CO 00337 Phone fees Name D. ''• Buma Conotruction Co. o` m Address I ICS yozi Mace o LOV01and a CO 80537 U License No. D — 2 Phone ° a Lot Block Filing Number N Subdivision} PUD f Parcel # DESCRIPTION OF WORK \i re s J ,Jr .w-'ri/•ice t` yy+ "w...<"f'. Stock oM /} Options 1^s6 Plan No. r^x Codes Est. Total Cost `~ 0 C:) (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. f slgned`,.r` '°"'^y, `"y '�. cJate•�� i N ,= CLASS OF WORK — New Alteration Addition Demolish Move O ❑` ❑ ❑ ❑ 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 Plan Check Permit .�r,✓,, Parkland City Sales Taxj�i"�=r., St. Oversizing ` Water Plant Investment Sewer Plant Investment Storm Drainage Electric Underground Total Fees ' -( -, i Distribution: Original - Applicant:•BI e - Off ce;Canary.- Sales Tax; PinkvApplicant'Tag - Bldg Insp. ! "� �' !1 Off -Street Parking (No. Cars) Interior Lot ❑ Corner Lot ❑ Reversed Corner Lot ❑ .o m } `m rr 0 ti Street c "> m. ADDENDUM ZBA Case # Date BBA Case # 4 Date Building Insp. r� -. Approval by (' "t f date I I ;�n/4 .. 71 PA& ///// i Permitt"No. Date r A�,