HomeMy WebLinkAbout5609 Cardinal Flower Ct - Applications/Solar - 09/28/2015Planning, Development and Transportation
City Of Building Services Department
6r}} 281 N. College Ave P.O. Box 580
I ` Collins 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):
8 Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # 136 w 1 `�
For office use only
Date 9/28/2015
Job Site Address (required)
Value of Construction (labor, materials, profit)
5609 Cardinal Flower Court
$14,250
.Property Owner Name Address
City/State Zip
Phone
Steve Wold 5609 Cardinal Flower Court
Fort Collins CO 80528
970-222-9423
Applicant Name Address
City/State Zip
Phone
Matt Scherer- GraySlone Solar 5644 Cardinal Flower Court Fort Collins, CO 80528
970-988-5682
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
3786-S(PV) Solar Purpose 7925 W Layton Ave #515 Denver CO 80123
303-548-3457
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
IB Here ❑ Report
sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑✓ No
30758865-0000
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ® Yes ❑ No
Is this a residential or commercial project? 8 Residential ❑ Commercial
If residential, is it: 8 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 8 No If yes, you may need to contact Historic Preservation
Description of work*
Installation of 8.1 kW roof mounted PV system, grid tied.
*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 Purpose 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:
Print Name: Matt Scherer
Signature
Date 92/24/2016