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HomeMy WebLinkAbout1 OLD TOWN SQ - PERMITS - 2/14/1984City 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 Ad>lIks r Name al Mail Address O l U{U •_ Phone �- y� W NameeT�+-e� LJIv(1 [Address 5� t 0 O U - -V !� License No. y (Phone Ufa c ° Lot Block - Filing Number nSubdivision PUD rn J DESCRIPTION OF WORK h Stock Options Plan No _ lodes_ Est. Total Cost (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. signed -- ---. __------- date'~ 7/ I- — CLASS OF WORK — —7 New Alterap'on Addition Demolish Move Fill Me❑c . 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 Engineering Fire Department Electric Department Water & Sewer Plan Review Special Conditions: Valuation FEES Plan Check Permit Parkland City Sales Tax ,- StOversizing Water Plant Investment Sewer Plant Investment Storm Drainage - Electric Underground ---- - Total Fees ,.,-., ^ ­'^- ^ �"'iP - �PPn(-dill_ dme - UTTme Canary - Sales Ta. Pinl, - Apphcanl. Tag - Bldg Insp I ( Off -Street Parking -� (No. Cars) Interior Lot ❑ Corner Lot ❑ Reversed Corner Lot ❑ a m r m m a � m � r 0 0 l Street c 0 „ ZBA Case # Date BBA Case # Date Building Insp. Approval by date 150q 2— Permit No. Date