HomeMy WebLinkAbout2415 Palomino Dr - Applications/Solar - 06/03/2015City of
/ 01 rt 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):
Z Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # 2215 del Z . Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name Address
City/State Zip
Phone
7 -r '1555 S V".I , ion C.t- (90Q 1 cl Co
23-c188-Cb6I
Applicant Name Address
City/State Zip
Phone
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Solar Contractor License #/Co. Name Address
City/State Zip
Phone
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
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? 10 Yes ❑ No
Is this a residential or commercial project? 9 Residential ❑ Commercial
If residential, is it: 19 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 29 No Ifyes, you mayneed 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
listCity Registered Plumber) GwaecLPA F'0yL--r0u
Electrician E-Z Effect:.crx1 Plumber Roofer (Forsolar-PV shingles) Avr "(�
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: t�
Print Name: GtL. J. r rnc0.. 6 Signature �,� =�� Date E-343-