HomeMy WebLinkAbout4112 MOUNT VERNON CT - PERMITS - 8/14/1985City of Fort Collins
BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Job Address WIZ- ;,�T ✓P�NOK1
Name
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Mail Address
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Phone
Name f
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Address
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License No.
Phone
a
Lot
Block ` ,
Filing Number';
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Subdivision
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PUD
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DESCRIPTION OF WORK
Stock ", Options (, r
Plan No. . �1 Codes -
Est. Total Cost fr
(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.
sigheu " date
— CLASS OF WORK —
New. Alteration Addition Demolish Move
❑ ❑ ❑ ❑
b Mech. Elec. Struct. Fire Prot.
Occ. Gr.
Type Const.
Use Zone
Use of Building JF%zi
Floor Area
Height
No. Stories 7
Lot Area -,'I i
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
Distribution. Original - Applicant, Olve - 104,ce: Canary -Sales Tax. Pink - Applicant Tag - Bldg. Insp.
t
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑'
Reversed Corner Lot ❑
d'
2
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Street) i
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
bydate
Permit No.
Date -