HomeMy WebLinkAbout4501 REGENCY DR - PERMITS - 7/15/1985City of Fort ColllnS BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Pre s firmly using ball point pen.
Job Address
Name
Mail A ddress 4
3
O
Phone _ �—
0
Name
Address 6 u
c
0
TnPT
U
License No.
Phone '
°
n-
Lot
Block Filing Number
y.
Subdivision
o,
PUD
m
DESCRIPTION OF WORK
2-
-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 state laws regulating building construction.
s;3ned date
r
1
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plb'g. Mach. Elea Struct. Fire Prot.
Occ. Gr. is
Type Const.
Use Zone
Use of Building
Floor Area i
Height
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
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
uisnouncn- Original - Applicant, Blue - Otfice. Caueiy - Sales Tax. Pink - Appiicant', Tag - Bldg Insp.
Off -Street Parking
(No. Curs)
Interior Lot
❑
Corner Lot
❑
Reversed Corner
Lot ❑
m
`m
0
Cr
^^
Z
W
n
} Co
0
�LL
Street
c
0
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Permit' No.
Date