HomeMy WebLinkAbout810 E MYRTLE ST - PERMITS - 7/18/1985City 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.
.fob Address PYIQ t N TL-0
Name
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Mail Address
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Phone
Name
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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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DESCRIPTION OF WORK
Stock Options
'PlanNo._ —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.
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signed date -
- CLASS OF WORK -
Ne A ration Addition Demolish Move
❑ 14❑ ❑ ❑
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.
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 Fes
Distribution Original - Applicant. blue - Office. Caqar Sales Tax, Pink - A icant Tag Bldg Ins
9 PP Y- PW 9- 9 P-
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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Street
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ZBA Case # Date
BBA Case # Date
Building
Insp. Approval
by
date
Permit No.. _
Date