HomeMy WebLinkAbout626 LOCUST ST - PERMITS - 6/24/1987City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name TArni L. S Lhir5ttk
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Mail Address (� ti� Lp LVj+ 54--
Phone "3
Name 5/..3'Mc 0 wnCJQ
o
m
Address
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U
License No.
Phone
0
.-
Lot
Block
Filing Number
0
Subdivision
o
PUD
m
Parcel
DESCRIPTION OF WORK
13 S VgRE rC rp F-P
/tS half- Sjti ftl
fv
Stock Options
Plan No. Codes
Est. Totaf Cost d I SO 6) 1=
(including labor, mat rial, 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 slate laws regulating building construction.
signed date
— C
SS OF WORK —
New Alteran
❑
Addition Demolish Move
❑ ❑ ❑
Mbg. Mach.
❑ ❑
Elec. Struct.
❑ ❑
Fire Prot.
O
Occ. Gr. Type
Const.
Use Zo
Use of Building
Floor Area
ei
h
No. Stories
Lo A
Fro tag
Occ. load
cc.
he a from
Plat F' a
No.
Garage are
F
8 m . area
Type heat
o. Fireplaces or
stoves
— RELEASES —
Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation A itffi
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
❑
m`
cc
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ti
f 1
l 1
d
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✓LL
Street
PRMTS
17.50
TAXPM
13.75
o TOTL
31.25
a
CHCK 31
> N41140 10:54 A
JUN.^c4'87
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
—d#date
by
Permit No.
Date
25
nislrlpution: Original - Appl¢ant: Slue - Office'. Canary - Sales Tax: Pink - Applicant Tag - Bldg. Insp.