HomeMy WebLinkAbout416 N ROOSEVELT AVE - PERMITS - 5/2/1986City 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 A O 61
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Mail AddressA°CIO %
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Phone
Name A
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Address
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License No. Phone
Lot
Block Filing Number
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Subdivision
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PUD
Parcel #
DESCRIPTION OF WORK
R
Stock Options
Plan No.. Codes
Est. Total Cost
(including labor, mat4rial, 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 AdditlJon Demolish
❑ ❑ ❑
Move
❑
Plbg. Mach. E ec. Struct.
❑ Ek Cx ❑
Fire Prot.
❑
Occ. Gr. ,
Type Const.
Use Zone
1
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. Esmt. 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 p r
Y
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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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Permit No.
Date