HomeMy WebLinkAbout416 E PLUM ST - PERMITS - 12/13/1986City 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 167 E t l ,4-,e,
Name
c
Mail Address
3
O
Phone
Name
0
Address
c
0
U
License No.57
Phone 3
°
a
Lot
Block
Filing Number
y
Subdivision
PUD
rn
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
E-zt. Total Cost ' 1
(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 Alte n" Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. . Mile 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 _
Distribution. Original - Applicant. 61pe —Office. Canary - Sales Tax. Pink - Applicant; Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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d
Cc
V
1 )
1 )
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c
0
lL
J
Street
C
O
R
ZBA Case #
Date
BBA Case #
Date
Building
Insp. Approval
by
date
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Permit No.
Date