HomeMy WebLinkAbout930 W MOUNTAIN AVE - PERMITS - 5/13/1987City 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 " �
Name rvc_z- (rya ;-tZr—
`m
c
Mail Address `73C c.J ry7yf/..
O
''-
Phone Zf f3 . 3e, C C
0
Name
Address 71rj C ix1-cizC �J
License No. tm E Z,1, (
Phone znzq — 5C-C( c
Lot
Block
Filing Number
Subdivision
o
m
PUD
rn
I Parcel -41,-
DESCRIPTION OF WORK
w T E�C,rC�•
�137-114a
Stock Options
Plan No. Codes --
Est Total Cost _
(including iabor, 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
or and state laws r sting building construction.
Gi 1
.Signed date
C
— CLASS OF WORK —
New Alteratllv6 Addition Demolish Move
❑ le ❑ ❑ ❑
Plbg. Mech. Elec Struct. Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
H
g
No. Stories
Lqt e
Fro ge
Occ. load
cc. Fhlalo?�,,
Plat File N
o. .0
Garage area
t. area
Type heat L
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 r
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
_
Total Fees
63T1,16ution. Original - Applicant. Blue - Office'. Canary - Sales Tax. Pink - Applicant. Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
�n
m
d
_IV
m
^
m
c
0
ti
Street
PRMT1
1,.00
TOTL
15.00
C
CHCK
15
N29934 10:44 A
MAY.1787
ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
date
!�
1
i r✓
Permit No.
Date
Mi