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HomeMy WebLinkAbout2327 Tarragon Ln - Applications/Solar - 02/20/2015City of 6rt Collins Planning, Development and Transportation 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): ❑X Photovoltaic Solar (PV) ❑ Thermal Solar (Hot Water System) Complete all applicable information on the application. Incomplete applications will not be accepted. Application # R 15 O 1©- (p Date a - ac -1 For offlIce use only Job Site Address (required) Value of Construction (labor, materials, profit) 2327 Tarragon Ln 8583.3 Property Owner Name Address City/State Zip Phone Hines, Allison Same as above 970-227-5462 Applicant Name Address City/State Zip Phone Solar City 470 E 76th Ave #3A Denver, CO 80229 303-902-3957 Solar Contractor License #/Co. Name Address City/State Zip Phone Solar City 470 E 76th Ave #3A Denver, CO 80229 303-902-3957 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑X Here ❑ Report Sales tax number is required by all contractors. Are you paying with your trust account? ❑ Yes ❑X No IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Qx Yes ❑ No Is this a residential or commercial project? ❑X Residential ❑ Commercial If residential, is it: QSingle 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* Install a 4.59 kW roof -mounted grid -tied solar PV system *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 Solar City 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: Brent Kocis� 2/19/15 Print Name: Signature � �"-�- Date