HomeMy WebLinkAbout1331 Patterson Pl - Applications/Solar - 08/02/2017Planning, Development and Transportation
City of Building Services Department
281 N. College Ave P.O. Box 580
/.F6r`} CollinsllFort 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 # F) �I T)4-a9 1) Date nfs 16? 1 2o�'
For office use only 1 439 `(O
Job Site Address (required)
Value of Construction (labor, materials, profit)
I
r en &C>S21�
Property Owner Name Address
City/State Zip
Phone
as
v- q, I -(ol
Applican ame Address
City/State Zip
Phone
Ecomark Constuction 4665 Paris St. #300-C Denver/CO 80239
505-250-0088
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S3606/ Ecomark Construction 4665 Paris St.
#300-C Denver/CO 80239
720-432-6411
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
&Here ❑ Report
Sales tax number Isrequiredbyall con"ctom
Are you paying with your trust account?
❑ Yes S(No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes
Is this a residential or commercial project? &� Residential ❑ Commercial
If residential, is it: YSingle 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 VNo Ifyes, you mayneed to contact Historic Preservation
❑ No
Description of work*
3.0* KWDC, Rooftop, Flush -Mounted, PV Solar system, Utility interconnected, lA Modules
*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: Chris Gibney Signature Date CS' I oZ 120V1