HomeMy WebLinkAbout424 PINE ST - PERMITS - 3/17/1986City
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 % l n v S+
Name rirKG/ md/ll� .Jt/Urcei
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Mail Address
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Phone
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NameE at
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Address
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License No.
Phone
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Lot
Block
Filing Number
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Subdivision ,
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PUD
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DESCRIPTION OF WORK
P iC I
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Stock Options
Plan No. Codes
Est. 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 slate laws regulating building construction.
signed date
— CLASS OF WORK —
Ne Alteration Addition Demolish Move
b M eO . Eii c. Struuct: Fire rot:
rl
Occ. Gr.
Type Const..:
Use Zone
Use of Building
Floor Area
Height
No. Stories _
Lot Area
Frontage
Occ. load rf`
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:
f
Valuation FEES
Plan Check f,
Permit
Parkland
....._..:..._..._
City Sales Tax
x ;"
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Tot I Fees
Distribution Original - Applicant. Blue _ Office, ;Canary - Sales Ten, Pink - Applicant. Tag 'Bldg. Atij..
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
a
m
`m
m
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f • )
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Street
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0
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
1%W/ 7
31 i18&
Permit No.
Date