HomeMy WebLinkAbout1631 Kirkwood Dr - Applications/Solar - 11/16/2017Planning, Development and Transportation
City Of Building Services Department
I 281 N. College Ave P.O. Box 580
F6r`} Collins 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):
❑ Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # bil
For office use only
Date1-
Job Site Address (required)
Value of Construction (labor, materials, profit)
Y
'�$ZS
Property Owner Name Address
City/State Zip
Phone
L— it
I d a:!S
tcrM - (5 - q 12
Applicant Name 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
720432-6411
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
dHere ❑ Report
saiestax number isrequiredbyall contractors .
Are you paying with your trust account?
❑ Yes I'No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Yes ❑ No
Is this a residential or commercial project? MO Residential ❑ Commercial
If residential, is it: 9Single 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 I"No If yes, you may need to contact Historic Preservation
Description of work*
W , -� KWDC, Rooftop, Flush -Mounted, PV Solar system, Utility interconnected, (S 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 11 / 17 / 2A 11