HomeMy WebLinkAbout3361 S Timberline Rd - Permits - 09/24/1987City of Fort CollinS BUILD ,ING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
JoblAddress 1
Name. �, t:e'rx.`� f .
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Mail Address • � !!!J�° �-1,d.i !may!.
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lf' Phone
Name i ,� /: j" -! A
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Address =� q^ -t t
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License No.
Phonej
Contractor Sales Tax No. J
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Lot
Block
Filing Number
y
Subdivision
M
PUD
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost e7' �- C' U
(including labor, material, profit)
I,hereby acknpwledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinWnces and state laws regulating building construction.
signed d t
— CLASS OF WORK
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
_
Plbg. Mech. El Struct. Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr.
Type Cons .
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
i
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
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uisvibuiion. Griginai - Ayyiicani, oluc - v��,ceanary - .a�=� ^!r App!ican!' d !^g !.^.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. pproval
by date
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Lam'
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Permit No.
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