HomeMy WebLinkAbout925 KIMBALL RD - PERMITS - 9/3/1987City 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 oint pen.
Job Address t LG
Name
`
o
Mail Address
Phone —
`o
Name
m
/n
Address r✓l�-
`o
/
O
License No. — 3
Phone
c
°
Lot
Block
Filing Number
n
v
Subdivision
0
A
PUD
vParcel
ESC PTJOV OF WORK
Stock Options
Plan No. 4 Codes —
Est. Total Cos
(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
ordina e and stat laws r ulating-building construction.
43
signed date
— CLASS OF WORK —
New Alteration Addition Demolish
❑ ❑ ❑ ❑
Move
❑
Plbg. Mach. Elec. Struct.
Q ❑ ❑ ❑
Fire Prot.
❑
Occ. Gr. Type Const.
Use Zone
Use of Building
AreaOcc.
LHeightdLot
Chang.
2FloorArea
a
oves
— RELEASES —
Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
valuatio y,Z FEES
Plan Chec
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 ❑
ICE
( 1
f 1
in
�
in
`o
LL
"J
Street
PRMTS 38.50
°
TAXPM 31.60
TOTL 70.10
>
CHCK 7
N43178
09:39 A
SEP.04'87
ZBA Case It
Date
BBA Case #
Date
Building Insp.
Approval
by
date
27
9 -S J,B_(
Permit No.
-Date
10
DistributionOriginal - Applicant; Blue - Office: Can - Sales Tax: Pink - Applicant Tag - Bldg, Insp.