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HomeMy WebLinkAbout810 E MYRTLE ST - PERMITS - 9/19/1986City 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 ' Tt-1_ Name m c Mail Address 3 O Phone 0 Name m Address c 0 U License No. Phone 2 n Lot Block Filing Number y m Subdivision m PLO Parcel # DESCRIPTION OF WORK Stock Options Plan No Codes Est. Total Cost `I (including labor, material, profit) I hereby acknowledge that I have read this application and - State+hat -the above is correct -and -agree -to -comply -with allcity ordinances and state laws regulating building construction L signed _ d9te — CLASS OF WORK a New Alte rf 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 Froniage 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-- . ewer Plant- Investment - Storm Drainage Electric Underground _ Total Fees Distribution_ Original - Applicant, Blue - Office'. Canary - Sales Tax. Pink - Applicant. Tag- Bldg Insp. Off -Street Parking (No. Cars) Interior Lot ❑ Corner Lot ❑ Reversed Corner Lot ❑ } m ar Ir m � m r c 0 li Street c 0 a ZBA Case # Date BBA Case # Date Building Insp. Approval by date Permit No. Date 1