HomeMy WebLinkAbout1418 CENTENNIAL RD - PERMITS - 9/19/1986City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmlyusing ball point pen.
Job Address .'r Fir.Z c,P.�y%ir,.-v rff�
Name X .t�. rCles
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Mail Address e;111"
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Phone ry 4;13 0 74
Name
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Address
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License No.
Phone
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Lot
Block
Filing Number
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Subdivision
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PUD 5_05:�'115'
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Parcel
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost -
(including labor, material, profit)
I hereby acknowledge that 1 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.
signed e
F,
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Loi 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:
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Valuation FEES
Plan Check
Permit
fin.
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
To a Fieaj.
.�.
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 a Date
Building Insp. Approval
by
date
Per —„
Date
Orstrib.t1.n 01i9inal - APphcam; Blue - Jffte, Canary - Sales Tax; PAnk - Appii"rn Tag - Bldg. Insp. `" v • J