HomeMy WebLinkAbout613 JACKSON ST - PERMITS - 9/24/1987City 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 6,13 T AGrCSOM1f T ,
Name V t .T01L H, S pi,4r+47—
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Mail Address 133 y Ale-
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F�T U1.{..t 0 2l
Phone 'YSZ-3-7Z07
Name J� NAMIC; i�G RIG 1"C.,
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Address 'P,U, , O'A CW 07 3
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C12 K i. O slusZ S
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License No. MF-306
Phone•Z23'2 /
Contractor Sales Tax No. '0 23 0 7 !/
ZO
Lot //
Block
Filing Number
b
d
Subdivision
PUD
v
Parcel# 97/04/-22-01/
DESCRIPTION OF WORK
JNOUF Rye tZ- Or,ST`.FT
Stock Options
Plan No. Codes
Est, Total Cost O o'^
(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.
9/2
date
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑❑ ❑
Plbg. Mech. I r S[ruct. Fire Prot.
❑. ❑ ❑ ❑
Occ. Gr. Type Con
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
Off -Street Parking
(No.
Cars)
Interior Lot
❑ -
Corner Lot
❑
Reversed Corner Lot
❑
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ZBA Case #
Date
BBACase# _
Date
Building
Insp. 1/ Approval
by�
date
-2:7 U8C� 1
9
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Permit No.
Date
.24
Distribution: Original - Applicant. Blue - Office. Canary - Sales Tax Pink - Applicant: Tag - Bldg, Insp. -
City of
Fort Collins
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BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE 'OF OCCUPANCY
• Applicant complete this part of form only.
Press firmly using ball point pen,
JobrAddress f l ;3s 'S 14GWSnrx? 4CT,
Name VrG1 Z X`i. �1` r•!i
m
c
Mail Address y AA r
3
Phone , .37a 07
Name rii V 2r wr
o
Address ..
0
m
rr < S
U
License No. ;r %V 1p,
Phone 2 1 - 7 C, f I
Contractor Sales Tax No. Xt 2� B ti 7 y
-c
°
a
Lot /
Block
Filing Number
v
Subdivision
m
PUD
m
ParcelN 7/04/-22-011
DESCRIPTION OF WORK
tNal F : 1z Y.-
Stock - Options
Plan No Codes
Est. Total Cost �—d
(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.
d[
— CLASS;OF WORK. —
New Alteration Addition Demolish
❑ ❑❑
Move
❑
Plbg. Mec h. III C. Struct.
❑ ❑ I ❑
Fire Prot.
❑
`'
Occ. Gr. Typ e Con t. t ,.
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
Tc�Ca1`jye
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
`m
cc
.,V
( I
1 )
d
m
_1
a
in
m
Y
y
0
JLL
Street
TA%U`11
nv.
-_3695 I0i_t' if
c
0
a
ZBA Case k
Date
BBACase#
Date
Building
Insp. Approval
by
date
2'] L�L_A_"
Permit NQ _
Date
Distribution: Original- Applicant; Blue - Off di .nary Sales Tax,.Pink >Applicant, Tag - Bldg. Insp.