HomeMy WebLinkAbout421 W MOUNTAIN AVE - PERMITS - 12/2/1986City 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 4 2
Name Mr. WjI/li4 h F
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Mail Address
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Phone 492--(rn/g?-
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Name (aA
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Address >,� V362.
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License No.
Phone 1Y3 -6,7 71
Lo �If l `t Y
Block
Filing Number
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Subdivision
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PUD
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DESCRIPTION OF WORK
13 b
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Ls
Stock Options
Plan No. Codes
Est. Total Cost'_!Y
(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.
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signed ,v ate
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— CLASS OF WORK —
e Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plb . Mech. Elec. Struct. F)re-Prot.
❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Uselone
Use of Building
Floor Area
Hei ht
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
j
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
_
Electric Underground
Total Fee
Disinbulion. Original - Applicant, Blue - . Canary Sales f a Pi - Applic t'Ta<f - Bldg. Ins 'j ( ` 1
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
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