HomeMy WebLinkAbout527 Muskegon Ct - Applications/Solar - 07/15/2017Planning, Development and Transportation
Clt)/ Of Building Services Department
��c rr•} •11 281 N. College Ave P.O. Box 580
�„�01 ` �0 �1 1S Fort Collins, CO 80524
/ `- Phone 970-416-2740 Fax 224-6134
SOLAR PERMIT APPLICATION FORM
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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 # t N 0�591tl 1 Date
For office use only
7j"/17
.Job Site Address (required)
Value of Construction (labor, materials, profit)
527 Muskegon Ct, Fort Collins, CO 80524
$15,000
Property Owner Name Address
City/State Zip
Phone
Lorae Blum 527 Muskegon Ct, Fort Collins, CO 80524
(970) 978-0020
Applicant Name Address
City/State Zip
Phone
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
CAM Solar. EC 101011 3443 S Galena
St, Suite 170, Denver, CO, 80231 720-729-8777
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ® Report
Sales &i6g i lrequredbyallconbaaors
Are you paying with your trust account?
❑ Yes IM No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? [] Yes
Is this a residential or commercial pro]ect? ❑ Residential ❑ Commercial
If residential, is it: 29 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 IN No If yes, you may need to contact HistoncPreseruatim
O No
Description of work*
Installation of flush -mounted Solar PV with 16 panels, 4.555kW, Solaredge Inverter &
optimizers.
*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 Oty of Ft Coffins license # (PV MUST list Oty Registered ElecYrloan — Thermal MUST
list City Registered Plumber)
ElectricianCAM Solar Inc 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: Signature Date
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