HomeMy WebLinkAbout901 COULTER ST - PERMITS - 4/18/1984City 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 Address ltL
Name O�
Mail Address
3
O
Phone
`o
Name
—
Address
C
0
U
license No. -
Phone
a
Lot
_
Block
Filing Number
N
_
Subdivision
0
PUD
rn
J
DESCRIPTION OF WORK
r
Stock Options
Plan No. Codes
-
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 — -- - —
— CLASS OF WORK —
New Alteration Addition Demolish Move
0 ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ 1 ❑ ❑
Occ. Gr. 3
Type Const. Use Zone
Use of Building
Floor Area
Stories
5HeightNo.
Lot Arearontage
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
w.
City Sales Tax
_
St. Oversizing
Water Plant Investment
"">j'""
Sewer Plant Investment
.7-
Storm Drainage
Electric Underground
Total Fees
., ��r— —un. urigrnai - /Applicant, blue - Office; Canary - Sales Tax. Purl. - Applicant, Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
}
m
a�
cr
aD
to in
c
0
LL
_V
Street
0
15
cits
ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Pe i No,
Date
- X