HomeMy WebLinkAbout914 W LAKE ST - PERMITS - 3/16/1987City of Fort Collins BUILDING INSPECTION DIVISION
V+; APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
Name
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Mail Address { r
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Phone ,_ 7
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Name
Address .f x { t .. x t L`
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License No, . ( Phone } 4-tJ ; c /
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Lot
Block
Filing Number
Subdivision
PUD
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Parcel #
DESCRIPTION OF WORK
Stock Options
Plan No. Codes
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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,
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signed date
- CLASS OF WORK -
New Alteration Addition Demolish Move
❑ Cl ❑ ❑ O
Plbg. 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 ',at t tt
Fire Department:'.
Electric Department
Water & Sewer
Plan Review.
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
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City Sales Tax
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St. Oversizing
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Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
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Total Fees
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
A
9
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Y
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LL
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Street
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I RECEIVED
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> MAR 16 1987
Ploultim Fin Auth0l"l '
BY ------
ZBA Case #
Date
BSA Case #
Date
Building Insp. Approval
by date
8 2 871
Permit No.
Date
Distribution. Original - Applicant: Blue - Office. Canary - Sales Tax: Pink - Applicant: Tag - Bldg. Insp.