HomeMy WebLinkAbout4501 SEAWAY CIR - PERMITS - 5/6/1984City
of Fort Col11nS BUIL'ING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT. AND CERTIFICATE OF„OCCUPANCY
Applicant complete this part of form uniy.
Press firmly using ball point pen.
Job Address , Opt
Name
c
Mail Address
O
Phone
`o
Name y 7 ' t
Address
��~ /.f i d I J e-�I
U
f
License No. 4 _ Phone
E
°
a
Lot
Block Filing Number
N
-
Subdivision
0
PUD
m
_I
DESCRIPTION OF WORK
I f "ram .✓ _ _ •' 1 ,. ' \ ',, �
J f '
Stock Options
Plan No. Codes
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
ordinancesiand state_laws�regulating building construction.
--- 'signed U
date
— CLAS§ OF WORK —
Ne(�/ ``Alteration"-�''Xddition Demolish Move
- ❑ ❑ ❑ ❑
P bg. Mech. 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 Taxes
\✓ rl.,r�f�n�
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total F es
Dist ribu I ion: Original -A pp I ic an 'CA ry - Sates TAx: ink - Appticani: Ta�_ "ft I pb
I --
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
rn
tv
m
ar
^^ m
} rn
C
0
ri
Street
r�r r:�esr 't
C
ca0
a
ro
ZBA Case #
Date
BBA Case #
Date
Building,
Insp. Approval
by
'j; - �~ date
Lig
Permit NO
i Date
? 100