HomeMy WebLinkAbout667 MANSFIELD DR - PERMITS - 5/27/1987City 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 67
Name Srn ) 'ru
`i
c
Mail Address
O
Ca11hS l/
Phone
Name
Address 36 W1,01,0196,W7,
, C6LGIIU5 COLD .
License No. —) 1 Phoney C —
Lot
Block
Filing Number
J--Parce'l
Subdvision
PUD
#
DESCRIPTION OF WORK
/
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
1 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 r ting building construction.
S',27-9
signed date
—CVOF WORK —
New Alterat' Addition Demolish Move
❑ ❑ ❑ ❑
_ Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
U e one
Use of Building
Floor Area
I ht
No. Storie
I I Fr nt
Occ. loaTO,c.
C an film
Plat File
.0
Garage area CW�Knu
Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions: -
09 O
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
❑
I-P
m
`m
C
0
LL
'J
Street
PRMTS
17.50
TAXPM
12.37
TOTL
29.87
CHCK ?
N20353 02:47 A
MAY.27'87
0
0
a
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by
date
/f
Permit No.
Date
Distribution' Original Applicant: Blue-`Bfllce: canary - Sales Tax: PinK -'Applicant; Tag - Bldg. Inap, - - -�— -