HomeMy WebLinkAbout5715 Coppervein St - Applications/Solar - 08/28/2017Planning, Development and Transportation
City of Building Services Department
I • r•� 281 N. College Ave P.O. Box 580
Foe1r�•* l CoLli s 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)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #
For office use only
Date
Job Site Address (required)
Value of Construction (labor, materials, profit)
5715 Coppervein St, Fort Collins, CO 80528 14688
Property Owner Name
Address City/State Zip Phone
James Zuhn
Same as above (970) 691-5215
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 0No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? 0 Yes ❑ No
Is this a residential or commercial project? OResidential ❑ Commercial
If residential, is it: OSingle Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
❑ Duplex
❑ Retail
Description of work* '
Install a 10.8 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: Digitally sig a by earoan,m
Prot Name: Benjamin Smythe Signature Benjamin Smythe Smy�be Date 8/25/2017
Dale. 2017.0 2510.5o:13 -09oly