HomeMy WebLinkAbout424 PINE ST - PERMITS - 5/8/1985City 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
Name C5X 6_1424r. scoqi. CBS
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Mail Address
3
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Phone
Name
o
Address
c
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License No.
Phone
Lot
Block
Filing Number
nSubdivision
d
m
PUD
m
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DESCRIPTION OF WORK
Stock Options
Plan No. Codes__ _
Est. Total Cost
imcludine 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 Demolishr
C1 ' ❑ ❑ ❑
Move
❑
Plbg. Mech. Elec. Struct.
❑ ❑ ❑ Q
Fire Prot.
❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Ar$a
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 k,j
t' r
Special Conditions:
s
—
,a.rt
1
Valuation FEI`S
Plan Check
Permit
Parkland
City Sales Tax
_ St. Oversizing-
Water Plant Investment
Sewer Plant Investment
-
Storm Drainage
Electric Underground
Total Fees
Disinnu;ron Ongm2l - Applicant. Blue - Ofhce Canary - Saies Tax. Pink - Applicant Tag - Bldg Insp
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
a1
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cr
0
0
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Street
a
5
ZBA Case #
Date
BBACase #
Date
Building Insp. Approval
by date
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T. i!
M /` 1 {Ay
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Permit No.
Date