HomeMy WebLinkAbout411 S BRYAN AVE - PERMITS - 10/15/1987 (3)City 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 n g_ rm hve .
Name e (� CO�IIJi
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c
Mail Address
o
(/ 5
Phone 2Z '!o(o!c
Name 5
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o
U
Address
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U
License No.
Phone
Contractor Sales Tax No. -
Lot
Block
Filing Number
.0
Subdivision
PUD
Parcel #
DESCRIPTION OF WORK
q
Y %�1
Stock Options
Plan No. Codes
Est. Total Cost � `
(including labor, material, profit)
1 hereby acknowledge that 1 have read this application and
state that the above is correct and agree to comply with all city
ordin,aaes a d state laws regulating building construction.
signed date
— CLASS OF WORK — ..
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone -
Use of Building (Q 5 t' !(/.�C.L,C-i
a
Height
ies
Lot Area
Frontage
d
Occ. Change from
;'fatFileNo.
No. D.U.
area
Fin. Bsmt. areaat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions: -
Valuation FEES
Plan Check
T-
Permit
5T. Z
Parkland
City Sales Tax }
St. Oversizing .
Water Plant Investment
Sewer Plant Investment
Storm Drainage
-
Electric Underground
-
Total Fees -
-
bff-Street Parking
-
(No. Cars)
Interior. Lot
❑
Corner. Lot
❑
Reversed Corner Lot ❑
m
`m
t
d
a
II
PRtMTS
PRMTS 157.27
4 CHCK
211,
Street 6
a
. ,1
0
ZBA Case #
Date
BSA Case#
Date '
Building Insp. - Approval
by date
'Permit No.
Date
n9
Distribution; original - Applicant Blue - Office. Canary - Sales Tax: Pink - Applicant, Tag - Bldg. Insp.