HomeMy WebLinkAbout321 Urban Prairie St - Applications/Solar - 12/07/2015 (2)City 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):
OX Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
I
Application # ��rJ(��5� Date
For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
321 Urban Prairie St Unit 2, Fort
Collins CO 80524 10210.2
Property Owner Name
Address City/State Zip Phone
SPEC lot 2D Block 02 Unit 02
Same as above NA
Applicant Name
Address City/State Zip Phone
Solar City
470 E 76th Ave #3A Denver, CO 80229 253-720-4461
Solar Contractor License #/Co. Name
Address City/State Zip Phone
Solar City
470 E 76th Ave #3A Denver, CO 80229 253-720-4461
Contractor City of Ft. Collins Sales Tax
#. Are you paying taxes here or by report? OHere ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account? ❑ Yes QNo
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? 0 Yes
Is this a residential or commercial project? QResidential ❑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
❑ No
Description of work*
Install a 5.46 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: 03itn::y signntl by JusLn CMI b
Justin Catlett Justin Catlett Snit! 2gtg.1].0215.02:09 12/2/2015
Print Name: Signature .m•g Date