HomeMy WebLinkAbout1 OLD TOWN SQ - PERMITS - 12/12/1983City
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 Addre r
Name
8
Mail Address
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O 1 1h
Phone/2.�,
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Name
Address
C
°
U License No. Phone -
Contractor Sales Tax No. a C)C) t
°'
Lot
Block Filing Number
N
Subdivision
PUD
Parcel # sZ _
DESCRIPTION OF WORK
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C
L,2SaeP,�►'-
Stock Options
Plan No._.__ _ Codes.
Est. Total Cost._.f
(including labor, rrtateria�], profit)
- 1-hereby-acknowledge that .Ihavn re.ad-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 Alter tion Addition Demolish Move
❑ ❑ ❑ ❑
Plbg.Eleo. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Occ. load
Dec. 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 xj,' . `r
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check'
Permit
E
Parkland
_
City Sales Tax_
St. Oversizing
Water Plant Investment
-Sewer Rant Investment
Storm Drainage
Electric Underground
Total Fees
Distribution Onginal- Apiiiy�drrt,a e-Ofllce.Canary-Sates is%.a k-Applicant. Tag-eltlg. lnsp.`_
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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( 1
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Street _
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ZBACase#
Date
BBA
Case #
Date
Building
Insp. Approval
by
date
2-103
Permit No.
Date