HomeMy WebLinkAbout612 REPUBLIC DR - PERMITS - 8/31/1988City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly us g ball point pen.
Job Address/'
Name--,,%.- zfG.
Mail Address
Phone
Name G %
a, Address
N
U LicenseNo. Phone
Contractor Sales Tax No. j G
-
�ot i_2 Block Filing Number
Subdivisio-•n�
PUD
Parcel # /�
DESCRIPTION OF WORK
Stock Options -sue
PlanNo__�-
Est. Total Cost _
(including labor, 5Xa4prial,"profit)
ereby cknowledge that I have read this application and
state that the ab ve is correct and agree to comply with all city
ordinances a laws re a ng building constr Lion.
ate
gned date
n
— CLASS OF WORK
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
--_
Plbg. Mech. Elec. Struct. Fire Prot
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const. Use Zone
Use of Building
Floor Area 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
Distnhvbon Onginal - Appli int. RWe - OPocc: Canary Saiu= Taa.Pmk - Appiicanr Tag - Hldg Insp.
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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Street
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ZBACase#
Date
BBA Case It
Date
Buildin In_sp.� L Approval
by VV �✓ TJ date
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Permit No.
-
Date