HomeMy WebLinkAbout410 WAYNE ST - PERMITS - 9/3/1986City
of Fort CollinS BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERhUT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address O
Name
`b
c
Mail Address
3
O
Phone
Name
o
io
ress n t
o
O
License No.
hone
n
Lot
Block
Filing Number
y
Subdivision
n
PUD
m
�
Parcel If
DESCRIPTION OF WORK
j
9�.9 todc
Stock Options
Plan No. Codes
Est. Total Cost r'
(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.
signed .may. call, �—
— CLASS OF WORK —
1
New Altergg!ion-'`Addition Demolish Move
El
Plbg. Mach. 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
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
[TotaP Fees
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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in
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Street
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ZBA Case#
Date
BBA Case #
Date
Building
Insp. 'Approval
by
data
ermit No.
Date
Distribution: Original - Applicant: Blue - Office: Canary - Sales Tax: Pink Applicant; Tag - Bldg. Insp.