HomeMy WebLinkAbout3646 Galileo Dr - Applications/Basement Finish - 12/30/2013City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1,30 6 423 APPLICATION DATE I lil3C i
Job Site Address y& (p Ck Unit #
t.
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone # ✓ / /
Last name .% u Cz /' -e Z First Name .) 0 -S e� Middle
Street Address 3 e'c/ tea 1? a m le-'dr- City Cn//L1n s StateZip POS�S�
CONTRACTOR INFO: Company Name %/Gys"LSolu't-luns Contractor Phone# -3ly. /
Lic Holder Name TD kl-,- / I 1 ) i .0-w City of Fort Collins License # P- 6.)9 Supervisor Cert #
Mailing Address 9 7 S6 ,6 w i !7 % C rt-o� Dr - City f 7<. C.o/ )r'h-1 State C_& Zip RSV X .-R a
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
1s' Floor Sq Ft
Comm'I Sq
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft fr 2 3 # of Bedrooms I # of Full Baths I % Baths '/z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: [XGas ❑ Electric Electric Main Breaker ]Size (-Res�idenn�tial only) ❑ 150/}Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ L�r 1 / ` f�- �- I f l • 5
,O1tQiDescription of Work:Jrlrt / A3 t4U �I
1
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical /te L311'' � /4% I
FramerS�e- / c"ud Roofing_
Solar
Other
Mechanical Plumbing ;ii
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature A,4Print Name %bh" %') ) ) 14-R2 Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE