HomeMy WebLinkAbout4144 SUMTER SQ - PERMITS - 9/2/1986City 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 77
Name
Mail Address r'
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Name
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,
Address
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License Noj,
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Phone e'
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a
Lot
Block
Filing Number
y
Subdivision
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PUD
01
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No.gVes_ _
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 Alta tlo Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
_
Use done
Use of Building
Floor Area
Height
No. Stories
Lot Ar
ontag
Occ.loa
ange
Plat Fi ✓
N
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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. Blue - Office Canary - Sales Tax'. Pink - Applicants. 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
RL��C l
Permit No.
Iflate