HomeMy WebLinkAbout4107 MILL RUN CT - PERMITS - 11/5/1986City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMJT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 4/07 Mi
Name S
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Mail Address
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Phone I (�
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Name hTic
Address
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License No.
Phone 3
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Lot
Block
Filing Number
Subdivision
PUD
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Parcel #
DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
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.
signed date
— CLASS OF WORK —
New Alter ' n , Addition Demolish Move
❑ ❑ ❑ ❑
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
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Uistnbu➢on'. Original - Applicant: Blue - Oitice. Canary - Sales Tax. Pink - Applicant. Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Permit No.
Dat