HomeMy WebLinkAbout1 OLD TOWN SQ - PERMITS - 2/19/1985City 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 Add r
Name Thou
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Mail Address zli i
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Phone
Name M 67��,. �XYL
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Address2 2-
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License No. — 1?hone
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a
Lot
Block
Filing Number
N
Subdivision
°PUD
s
J
DESCRIPTION OF WORK
k
Stock Options
Plan No. Codes _
i
Est. total Cost
_ _
lincluding 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 ----—--.----date---
— CLASS OF WORK
New Alte Lion Addition Demolish Move
❑ X❑ ❑ ❑
__
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑
_❑
Occ. Gr.
Type Const. _jUse
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
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
-y
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total' Fees -..
-......... on anginal - Applicant. Nlue- Office. Canary - Sales Tax Pink - Alin icanl Tag - Bldg Insp
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
ar
cr
( 7
(
f
C
�0
Street
c
0
ZBA Case #
Date
BBA Case it
Date
Building Insp. Approval
by date
2--1C1-
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Permit No.
Date