HomeMy WebLinkAbout3703 Galileo Dr - Applications/Single Family New - 06/05/2007BUILDING PERMITS & INSPECTIONS ❑IVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
CitVofFort Collins BUILDING PERMIT APPLICATION
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[APPLICATION NUMBER /®5��APPLICATION DATE � —� — O
Job Site Addressf ��� �� 11� Unit # Q p 2
PROPERTY OWNER INFO: (All o ner information is required — it is not optional) Phone J� -77 t) 1 �Y
Last Name First Name Middle
Street Address POCi �/l Dl /mi )[Y"S� _ State(b Zip
CONTRACTOR INFO: Company Name Contractor P/�honeQ#C��3���
Lic. Holder Nari�e i Y �=��i� f P City of Fort Collins License # 62 0 ( Supervisor Cart #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD `^� ` `fin Filing # Lot # Block # D Lot Sq Ft�y
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �yCn� Toottall Garage Sq Ft � 7
Residential Sq Ft Comm'I Sq Ft # of Stories O� Bldg Height 0� / / #Dwelling Units —I
1st Floor Sq Ft O` 2nd Floor Sq Ft "—) Unfinished Bsmt Sq Ft� Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths eog % Baths — /z Baths l # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. - ar w/Blower Do 5. Prescriptive w/Air Sealing 22 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #L44 List appropriate option #s r� 1:71
UTILITIES INFO:
Water Tap Size Is ILI
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Sewer Tap Size ^�- Metere Ye or No
Type of Heat: ❑ Electric
Value of Construction including labor
Description of
Contact Name & Phone # of JOBSITE
Electric Main Breaker Size ( sldential on
=rial & profit) $ 1 9 q3
T
Temp. Pedestal: es r No
Amp or Less ❑ 200 Amp ❑ Other
Subcontract Info:
Electrical) MPC tnica1419CtaL6-2R3-V1j& Plumbing bo/�i
Framer Roofing 'e�9 x9lConcrete Other tit—� Yt i
Applicant: I hereby ackno ledge that I have d this application and state that the above information is correct and agree to comply with all requirements
contained he nd City 6 Fort Co>llins o®rdci anc 7 state laws regulating building construction.
tklle ,-----�� r � — Print Name ,' I`V Akdter-
��Applicant Signa Phone��� �I
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE