HomeMy WebLinkAbout2551 Sunbury Ln - Applications/Solar - 07/31/2017Planning, Development and Transportation
City Of Budding Services Department
281 N. College Ave P.O. Box 580
Forr} ` Collins r1 IS 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):
❑X Photovoltaic Solar (PV) -1 U g , 34
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted
Application # eyiT3 4ati j
For ofFice use only
Date
-1h5ill-I ' , I
Job Site Address (required)
Value of Construction (labor, matenals, profit)
2551 Sunbury Ln, Fort Collins, CO 80524 15504
Property Owner Name
Address City/State Zip Phone
Todd Isis -
Same as above (970) 270-2008
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 ❑ Report
Sales tax number Is required by all contractors
Are you paying with your trust account? ❑ Yes ❑X No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Qx Yes
Is this a residential or commercial project? QResidential ❑ Commercial
If residential, is it QSmgle 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 morel ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
13 No
Descnpbon of work*
Install a 11 4 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 Coffins license # (PV MUST fist Oty Registered Efectncian - mermal MUST
fist 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: °9m'y sg a by M%Hmm
Print Name. Benjamin Smythe Signature Benjamin Smythe sw" Date 7/28/2017
Date W1707280726214nu