HomeMy WebLinkAbout2712 Garden Dr - Applications/Solar - 04/01/2013LL �
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city Of Building Services Department
��®����� 281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
.�✓' '� Phone 970-416-2740 Fax 224-6134
SOLAR PERMIT APPLICATION FORM
This application is to be used to apply for the following permits only (check the appropriate box):
❑ Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #_ 113 5 Date �� I
For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name Address
City/State Zip
Phone
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Applicant Name Address
City/State Zip
Phone
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Solar Contractor License #/Co. Name Address
City/State Zip
Phone
501ar;}. 'P110 - 70'�'-
Ave-vd- 0 Q 30024
7 nst — 6oS
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required byall contractors .
Are you paying with your trust account?
❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or c mmercial project? IJ Residential ❑ Commercial
If residential, is it: 53 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
Description of work*
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*Please note in description if; roof Flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels.
Subcontractors: List the company name or City of Ft Collins license # (PV MUST list City Registered Electrician - Thermal MUST
list City Registered Plumber)
Electrician Plumber Roofer (For solar PV shingles)
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: tai i Wn ,hgj� Signature �ntN W Date
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