HomeMy WebLinkAbout1512 Kirkwood Dr - Applications/Solar - 01/13/2016Iglahning, Development and Transportation
City of Building Services Departrnent
F6rt Collins 281 N. College Ave P.O. Box 580
.7 Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
SOLAR PERMIT APPLICATION FORM
?Photovoltaic
application is to be used to apply for the following permits only (check the appropriate box):
Solar (PV)
❑ Thermal Solar (Hot Water Systems)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #_ �I C.00 I s0 Date 11,3Z 16
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
�C�III
2 I9 ZD .00
Property Owner Name Address
City/State Zip
�� Phone
C-Al en Svh��h
q70-93-Y1 fz
Applicant Name Address
City/State Zip
Phone
I
I M � 6o�
20-9.20
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S' N co imArk COASINCAM4463
Awi -k 61300 -C cv, goof
720-620•
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required by all contactors
Are you paying with your trust account?
❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJECTrResidential
N PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or commercial project? ❑ Commercial
If residential, is it: liSingle 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
*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 MUSTIist 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: l
Print Name: �WiO O l OT Signature OrV G Date �'