HomeMy WebLinkAbout3808 Galileo Dr - Applications - 11/26/2002i�
City of Fort Collins
BUILDING PERMTrS & INSPECPIONs DMSION
P.O. Box 580 • Fort Collins, CO 80522 0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last j First
c Street Addre P/easq p cify. LN. DR. CR. WY PL., ST. CT. RD. AVE.
Middle Phone
N 5 90-?�
City Stat Zip Code
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Supe,C fiery
State Zip Code
Code
Please Specify: LNDRCR. WY. PL. ST. CT. RD. AVE. Zip Code
JOB SITE ADDRESS
�SsD6' 611� bj�. , l o P R c�
CM
D 60
Filing upper
Lot Block
Lot Area
C
Building Square Foota a
Number ofries
L
Number of Dwelling, Units
Number of edr ms/Bathrooms Unfinishei
Stock Plan Numpar0pti+
onj
Ra
Energy Sco
N
y
Water Tap Size ,
Sewer Ta Si e
2
a of Heat:
Electric Main Breaker Size (Residential Only)
Te porary Electric Pedi
as ❑ Electric
Ar150 amp or less ❑ 200 amp ❑ other
s ❑ No
(including labor, material, profit) $
a a
,
Description of Work: // _ _ , ' e Jn
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Job Contact Name & Phone _
l ►'Yf' v 1 �iC_ cr 1,�� a 3-`�/`� �4) 7�
Subcontractor Namys: �/ d
Electrical 'd ) / & Mechanical /7 Plumbing /Z
Framer:KW Roofing 4) /- Concrete
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requiremeZconedherein and city ordinances and state laws regulating building construction.
R
a Signature
a � _
Print Name {� Phone j, 03 7 V
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE