HomeMy WebLinkAbout4249 MCMURRY AVE - PERMITS - 12/3/1986City 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 q
Name
d
c
Mail Address -
3
O
Phone_ —
`o
Name r' S
Address
c
0
U
License No.
g
n
Lot Block
Filing Number
Subdivision
m
PUD
m
Parcel #
DESCRIPTION OF WORK
T
t
_r
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 datei � -
Disinbution: Original-App nL.Dluec Oltice'Canary\,Sales Tax:Pink\ Apphcant; Tag-BIJg. In
— CLASS OF WORK —
New Alte a on Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. ec . Elec. Struct. Fire Prot.
❑ ❑ El ❑
Occ. Gr. Type Const.
Use Zone
Use of Building ,S��Z
Floor Area
Height °
No. Stories
L'ot Area
r
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:
r
Valuation FEES -
Plan Check
Permit
f
Parkland
City Sales Tax
•�
- /1- f'��
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
❑
to
`m
_Nv
0
Street
0
76
4BA'Case#-- ..
Date
BBArase#
Date
..:
.puilQing Insp. ` Approval
by ..,:; date
Permit No.
Date
,4�
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