HomeMy WebLinkAbout703 Dearborn St - Applications/Solar - 03/29/2016Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
F61r t Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
PERM J ��Li i� i �-.F RN i
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 #
15110,01599
For office use only
Date -3 /,;? 9 / (D
Job Site Address (required)
Value of Construction (labor, materials, profit)
703 Dearborn 'Street;- Fort Collins CO 80525 13127,4;
Property Owner Name
Address City/State Zip Phone
Kurt Pillote ;:::.: ::.
Same..as above ;..::(.97Q) 305=7933.
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? ❑X Here 0 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 ❑ No
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 Ifyes, you mayneed to contact Historic Preservation
Description of work*
Install a 7.02 ' 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- Digitally signed by Chris Johnson
PP Date: 2016.03.2508:05:03 3/25/16
Print Name: Chris Johnson Signature Chris Johnson :06.00 Date