HomeMy WebLinkAbout919 Kingston Dr - Applications/Solar - 12/23/2015Planning, Development and Transportation
City of Building Services Deparbnent
281 N. College Ave P.O. Box 580
For } ` 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):
❑ Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #
For office use only
Date
lob Site Address (required)
Value of Cons ruction (labor, materials, profit)
I K;� ,540' Dr
T 111gg0
Property Owner Name
Address
City/State
Zip
Phone
b i,8 rYL64I / *f k; A
s4o e, -Or
0- 646,41 1 Lb.
S os25-
Ogyo, W ► - DOW
Applicant Name
Address
City/State
Zip
Phone
Hal Aq,k-*,, Opo E.
50} Ae
i,.,tm., Lo.
e02 300
-/O/y
Solar Contractor License #/Co.. Name
Address
City/State
Zip
Phone
5-gys-PV
C%o0 U.
Lv. Sozm
- (?V5)T0y _=6
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes
here or by report? Nor Here ❑ Report
Sales tax number isrequiredbyall contractors.
529og
Are you paying with your trust account?
❑ Yes .19 No
'
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or commercial project? JR Residential ❑ Commercial
If residential, is it: JR 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? JKYes ❑ No If yes, you may need to contact Historic Preservation
Description of wor
S . i3 3w S�Imc PV s 0w, „ 4eo4 -b roof,
604e4l, bowkW U.'&U.s
*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 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:' v 51--b44 (tAA e Signature Date