HomeMy WebLinkAbout5607 Pleasant Hill Ln - Applications/Solar - 05/08/2015City of
Flirt 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):
❑ Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # B1503349 Date 5/8/2015
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
5607 Pleasant Hill Ln, Ft Collins,
CO 80526 17441.00
Property Owner Name
Address City/State Zip
Phone
Bzdek, Justin
5607 Pleasant Hill Ln, Ft Collins, CO 80526
970 222-9178
Applicant Name
Address City/State Zip
Phone
Tracey Morris
4571 Broadway, Boulder Co 80304
919-622-3772
Solar Contractor License #/Co. Name
Address City/State Zip
Phone
Namaste Solar 4571
Broadway, Boulder Co 80304 919-622-3772
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
48551
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or commercial project? X Residential ❑ Commercial
If residential, is it: Single Family Detached ElCondo/townhome (single family attached) El Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expon)
Is this building 50 years of age or more? ❑ Yes ;' No If yes, you may need to contact Historic Preservation
Description of work*
Installation of grid -tied (no battery) solar PV. Flush mounted to roof. 4.88 kW
*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 S-2075 Plumber Roofer (For solar PV shingles)
I hereby acknowledge that I have read this application and state that the aaregulat
omplete and correct. I agree to
comply with all requirements contained herein and city ordinances Ytd stading construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: Tracey Morris Signatu aDate 5/8/2015
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