HomeMy WebLinkAbout901 COULTER ST - PERMITS - 4/24/1984City 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.
JobAddress
Name
Mail Address
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Address
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License No. — .� -�
Phone
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Lot LBlock
Filing Number
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Subdivision ' ;. ►;;� a f V� 4 += K.�aicp
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DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
Est. Total Cost }
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(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.
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--
,— signed
--- -=--date, --
— CLASS OF WORK —
New Alteration Addition Demolish Move
a-- ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone f -
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Occ. load
Occ. Change from
Plat File NO. ' i',. -
No. D.U.
Garage area . ,
Fin. Bsmt. area
Type heat ;,
No. Fire laces or stoves
— RELEASES — Dates
Zoning
Engineering `
Fire Department
Electric Department
Water & Sewer
Plan Review r ; - - i i V
Special Conditions:
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Valuation %` , ; :�s ?? FEES
Plan Check
Permit
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Parkland
City Sales Tax
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St. Oversizing
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Water Plant Investment
Sewer Plant Investment
.Y
Storm Drainage
Electric Underground
Total (fees
Off -Street Parking
(No. Cars)
Interior Lot
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Corner Lot
❑
Reversed Corner Lot
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
637
Permit No.
Date
Distribution. Original - Applicant, Blue - Office: Canary - Sales Tax: Pink - Applicant: Tag - Bldg, Insp.