HomeMy WebLinkAbout321 Urban Prairie St - Applications/Solar - 12/07/2015 (4)City of
Fort 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 # 1?:�)Igf;0 � Date 2
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
321 Urban Prairie Unit 4, Fort Collins CO 80524 10210.2
Property Owner Name
Address City/State Zip Phone
Strevey, Scott and Hally
Same as above 9702175627
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? QX Here ❑ 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? Qx Yes
Is this a residential or commercial project? OResidential ❑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 Ifyes, you mayneed 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 9 (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: Justin Catlett Justin Catlett COiia iy s4 ned by Just n CaGsll
O; :e::0;5.12.02 13:33:01 12/2/2015
Print Name: Signature o7'00' Date