HomeMy WebLinkAbout3509 Shallow Pond Dr - Applications/Solar - 05/15/2017Fort Collins
Planning, Development and Transportation
Building Services Department
281 N. College Ave P.O. Box 580
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 # I I Date 5/15/2017
For office use only
Job Site Address (requ/red)
Value of Construction (labor, materials, profit)
3509 Shallow Pond Drive
$14,520
Property Owner Name Address
City/State Zip
Phone
Lindsay Kramer 3509 Shallow Pond Drive Fort Collins CO 80528
970-214-9327
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
S-3657 / GraySlone Solar 5644 Cardinal Flower Court Fort Collins CO 80528
970-988-5682
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? 8
Here ❑ Report
Sales tax number As required by all contractors
Are you paying with your trust account? ❑
Yes ❑� No
00134821
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? O Yes 13 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 9 No tfyes, you mayneed to contact Hlstonc Preservation
Description of work*
Installation of 7 AW roof mounted, flush mount PV system- gnd tied 22 panels total
*Please note In description if; roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels.
Subcontractors: Ust the company name or City of Ft Collins license # (PV MUST /1st 01y Registered Electr/clan — Thermal MUST
list City Registered Plumber)
Electrician ME-1407 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: 01J,
Print Name- Man Scherer Signature Date 5/15/2017