HomeMy WebLinkAbout932 E PITKIN ST - PERMITS - 9/20/1985City 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.
Job Address Z
Name �(�&A(
d
c
Mail Address
3
O
Phone ZZ 3 S d
Name bpz
o`
m
Address
c
0
U
License No.
Phone —
n
Lot
Block
Filing Number
y
Subdivision
A
PUD
rn
m
J
DESCRIPTION OF WORK
fI �io
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.
signed date
— CLASS OF WORK —
New Alteration ti Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec, Strl�cy" Fire Prot.
❑ ❑ Cf ❑' ❑
Occ. Gr. <
Type Const.
Use Zone k C_
Use of Building
Floor Areaii ii
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
,
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
VV .
(9
a
^
d
J)
ti
�v`
Street
c
0
R
ZBACase#
Date -
BBA Case #
Date
Building Insp. Approval
by
date
Permit 1
7
D to