HomeMy WebLinkAbout424 W MOUNTAIN AVE - PERMITS - 2/2/1987City 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 L / 171:'
Name i
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d
Mail Address
O
Phone
0
Name
Address
yp-
kx
License No.j r'
Phone %.. c : �-
C
°
n
Lot
Block
Filing Number
v
Subdivision
N
PUD
tT
Parcel #
DESCRIPTION OF WORK
i r
Stock Options
Plan No.- Codes
Est. Total Cost
(including labor, ma eriai, 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 A ter ion Addition Demolish
❑ ❑ ❑
Move
❑
Plbg. Elec.
❑ ❑ ❑
Struct.
❑
Fire Prot.
❑
Occ. Gr.
Type Const.
se Zo
Use of Building
Floor Area
ht
No. Stories
a
Frontage
Occ. loa
cc. Change fro
Plat Fit o
I . D
Garage area
in. Bs
. area
Type heat
N treplaces 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
13,
St. Oversizing
Water Plant Investment
Sewer Plant Investment
_
Storm Drainage
Electric Underground
Total Fees
_
Distribution Original - Applicant Blue - Office'. Canary - Sales Tax_ Pink - Applicant, Tag - Bldg- Insp
i
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m
m
d
Ir
_IV
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E
c
0
L
Street
PRMTS 19.00
TAXPM 13.75
TOIL 32.75
CHCtt 3
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M-06670 02:29 A
FEB.02'B7
ZBA Case # Date
BBA Case # Date
Building
Insp. Approval
by
date
' 3
,�
Permit No.
ate
.75