HomeMy WebLinkAbout416 N ROOSEVELT AVE - PERMITS - 10/21/1988City 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 (,.I A Roos evil jil
Name j I ri 4 N
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Mail Address._ !�
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Phone
Name t
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Address
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License No. 1 Phone
Contractor Sales Tax No.
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Lot Block Filing Number
y
Subdivision
°
PUD
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes —
Est. Total 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 Alteration Addition Demolish Move
❑ ❑ a ❑ ❑
—
Plbg. Mech. Elec. Stryct. Fire Prot.
❑ ❑ ❑ ,FJ ❑
Occ. Gr.
Type Const.
Use Zone , i
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 heaf
No. Fireplaces or stoves
— RELEASES — Dates
Zoning ;�
Engineering
Fire Department--�--_--�—_-_----_----
Electric Department
Water & Sewer
Plan Review
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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
Datribubol,. Original Applicant. Blue Office. Canary - Sales Tax Pink Applicant. T51a - Bldg. Insp.
Off -Street Parking
(No- Cars)
Interior Lot
Is
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBACase#
Date
BBACase #
Date
Building Insp. Approval
by date
30450
1
o ZI e
Permit No.
Date