HomeMy WebLinkAbout416 E PLUM ST - PERMITS - 9/11/1986City of Fort CollinS BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name
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Mail Address -
3
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Phone 0 7
0
Name
Address '
c
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-
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License No.
7 _
P h o n
n
Lot
Block
Filing Number
N
v
Subdivision
m
mu
PUD
a�
Parcel #
DESCRIPTION OF WORK
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 Alt ati n Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mq6h. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area Height
No. Stories
Lot Ail
Frontage
Occ. load
Occ. Change trom
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_
Tota�eesF
Distribution. Original - Applicant Blue - Office; Canary - Sales Tax'. Pink - Applicants. Tag - Bldg. nop
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
A
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in
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
�/Z
9/'02
Permit No.
Date