HomeMy WebLinkAbout121 S WHITCOMB ST - PERMITS - 9/18/1980City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING, PERMJT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Rob, Address IA-0 YZ I
Name
Mail Address
Phone
Name
g Address
U _
C
U License No. Phone
Contractor Sales Tax No.
° mot Block Filing Number
a
Subdivision
PUD
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost �A
(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
n.
ordinances and state laws regulating building constructio
signed date J
)Isvibunon: Original - Applicant, Blue - Office: Canary - Sales Tax: Pink - Applicant Tag - Bldg. main
CLASS OF WORK —
Press firmly using ball point pen.
Rob, Address IA-0 YZ I
Name
Mail Address
Phone
Name
g Address
U _
C
U License No. Phone
Contractor Sales Tax No.
° mot Block Filing Number
a
Subdivision
PUD
Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
Est. Total Cost �A
(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
n.
ordinances and state laws regulating building constructio
signed date J
)Isvibunon: Original - Applicant, Blue - Office: Canary - Sales Tax: Pink - Applicant Tag - Bldg. main
—
New Alteration Addition Dernolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mach. Ell Struct. Fire Prot.
El❑ ❑ ❑ ❑
Occ. Gr. Type Const. Use Zone
Use of Building
Floor Area Heighto. NStories Lot Area Frontage
Occ. load Occ. Change from
Plat File No. No.. D.U.
Garage area Fin. Ssmt. area
Type heat No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditionsn.� :
a
s4ii
. 5
i
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Off -Street Parking
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
m
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`m
v
IV
( 1 1 1
m 1 d
rn m in >
c
0
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Street
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OF
ZBA Case # Date
BBA Case # Date
Buildin Insp. Approva
by �,.. date�1 `
'(C7
Permit No.
ate