HomeMy WebLinkAbout619 Ramah Dr - Applications/Solar - 11/28/20142-/23/ 14
City Of
Fort Collins
Planning, Development and Transportation
Building Services Department
281 N. College Ave P.O. Box 580 —N
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134 :5-z� � i 3
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 # 49) f 4 Date I lict
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
619 Ramah Dr. Fort Collins, 80525
$11,444
Property Owner Name Address
City/State Zip Phone
Schafer, Jeffrey Same as above
(970) 372-0562
Applicant Name Address
City/State Zip Phone
Tom Nix 470 E 76th Ave 3A,
Denver, Co 80229 541-610-5930
Solar Contractor License #/Co. Name Address
City/State Zip Phone
SolarCity same as above +1 ix 9 5 a C.-Vrt . LDi^,'1
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? XHere ❑ Report
Sales tax number is required by allmntractom
Are you paying with your trust account? ❑ Yes XNo
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Ayes
Is this a residential or commercial project? Allesidential ❑ Commercial
If residential, is it: XSingle 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 Ifyes, you mayneed to contact Historic Preservation
❑ No
Description of work*
Installation of grid -tied PV system, flush mounted to roof.
6.12 xw
*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 iist City Registered Electrician - Thermal MUST
list City Registered Plumber)
Electrician SolarCity 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 r ing building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: Tom Nix ivzona
Print Name: Signature Date
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