HomeMy WebLinkAbout424 PINE ST - PERMITS - 7/3/1985City 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 , . . 1d S,
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Name LAiL(M�'G2 �Ory^/hU/1Ir
a� . Mail Address
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Phone
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Name �3f�i DGJ iAf N T _ ---
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Address
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License No.
phone -
Lot Block Filing Number
Z Subdivision
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PUD
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DESCRIPTION OF WORK
t h
Stock c Options
Plan No. t_ Codes --
Est. Total Costly
(includin aabe{, r�latel,�al,;oflq
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I herAbykkn wlagge{oat I have read this a lication and
state that fie a-bo is correct and agree to comply with all city
ordinancc,,a� sgate'javr`�'a(r lating building construction.
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signed-- '•, n date
— CLASS OF WORK —
New Alteration Addition Demolish Move
,Gl ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
o ❑ ❑ ❑ ❑
Occ. Gr. -
Type Const. ^r ...hji
I Zone
e
Use of Building (• 4 / l 0 r An f�
Floor Area -77 Height
No. Stories
Lot Area
F.,"rootage
Occ. loadt.r"'
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
Distnnonon Original - Applicant. Blue - Office. Canary - Sales Tar Pink -Applicant Tag - BI[itt Insp.
Off -Street Parking
(No. Cars)
Interior Lot
+D
Corner Lot
❑
Reversed Corner Lot ❑
m
m
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n
m
0
0
LL
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in
Street
C
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
169 6
W3/8 s
Permit No.
Date