HomeMy WebLinkAbout4827 Prairie Vista Dr - Applications/Solar - 08/12/2016Planning, Development and Transportation .
City of Building Services Department
281. N. College. Ave P.O. Box 580
/+F6r6♦ 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):
QPhotovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application.: incomplete applications will not be. accepted.
11 'n
Application # 1 10 lU Date
For office use only . .
Job Site Address (required)
Value of Construction (labor, materials, -profit). ..
4827 Prairie Vista Dr, Fort Collins CO 80526 16044.6 -
Property Owner Name
Address City/State Zip Phone
Kay O'Connell
Same. -as above.: (970).682-11.61. .
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-03A Denver, CO 80229 253-720-4461
Contractor City of Ft: Collins Sales Tax # Are you paying taxes here or by report? QHere ❑Report
5a/es tax number is required by all contractors
Are you paying with your trust account? ❑ Yes ZNo
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Qx Yes 0 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, !sit: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building SO years of age or more? 0 Yes ❑ No If yes, you may need to contact Historic Preservation
Description of inlork*
Install a 8.58 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: Justin Catlett
Print Name:
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Digitally signed by Justin Catlett
Justin Catleft Date: 2016.06.1015:45:57 8/10/2016
Signature os•00. Date