HomeMy WebLinkAbout2407 Leghorn Dr - Applications/Solar - 08/25/2017Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
F ofrrr��•} ` Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134 l4J
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.)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # b IN
'
For offilce use only
Date
Job Site Address (required)
Value of Construction (labor, materials, profit)
2407 Leghorn Dr, Fort Collins, CO 80526 5304
Property Owner Name
Address City/State Zip Phone
Kristin Mahrt
Same as above (970) 556-8261
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? F] Yes ❑ No
Is this a residential or commercial project? QResidential ❑Commercial
If residential, is it: OSingle 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 ❑ No If yes, you may need to contact Historic Preservation
Description of work*
Install a 3.9 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: Benjamin Smythe j Smythe D®IallyegneObyBe emn 8/24/2017
Benjamin Sm he �e
Print Name: Signature Date: 2017.08241d W55-0 a Date