HomeMy WebLinkAbout801 GALLUP RD - PERMITS - 7/25/1984City of Fort
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Collins BUILDING INSPECTION DIVISION
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APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address wl Sa.I I up Rd.
Name Richard Freeman, Jr.
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MailAddres108pl Naliup Rd.
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Fort Collins, Colo. U0521
Phone 484-8185
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Name
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Address Same as above
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License No.
Phone
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Lot
Block/�
Filing Number
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Subdivision 8fl1 Ga11�ap Rd♦
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PUD ort Collins, Colo 80521
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DESCRIPTION OF WORK
(replace)
Stock 'Options
Plan No. Codes
Est. Total Cost 11000.00
(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.
f signed
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— CLASS OF WORK
New Alteration Addition Demolish Move
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Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
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 ✓.7,-• .>l �lf:�
Engineering r
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:.`
Valuation FEES
Plan Check
Permit
2
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
otal Fly ,ees
Distribution'. Original - Applicant` Blue -Office, Canary -Sales Tax: Pink -_Applicant. I ag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner
Lot ❑
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Street
F'P'7TS 23.6)22
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JELL e 25
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ZBA Case #
Date
BBA Case #
Date
Building Insp.�
Approval
by
date
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(Permit Nod' �
Date
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