HomeMy WebLinkAbout313 E Saturn Dr - Applications/Solar - 11/22/2017I Planning, Development and Transportation
City Of Building Services Department
281 N College Ave P O Box 580
For} ` 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 #
For office use only
Date ( I Aai 11-1
Job Site Address (required)
Value of Construction (labor, materials, profit)
313 Saturn Dr, Fort Collins, CO 80525
$6,720 00
Property Owner Name
Address
Oty/State Zip
Phone
Barbara King
313 Saturn or
Fort Collins, CO 80525
(970) 988.6399
Applicant Name
Address
City/State Zip
Phone
CAM Solar
3443 S Galena St #170, Denver, CO 80231
720-729-8777
Solar Contractor License #/Co. Name
Address
City/State Zip
Phone
CAM Solar EC101011
3443 S Galena St
#170, Denver, CO 80231
720-729-8777
Contractor City of R Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sates tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
I F SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CI TY U GHT AND POWER? O Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® 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 more9 ❑ Yes ❑ No Ityes, you may need to contact 1-Gstonc Preservation
Description of work'
3.36kW Flush mount interactive rooftop installation of 12 modules
`Please note in description if, roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels
Subcontractors: Llst the company name or Oty of R Collins ficense # (PVMUST11s1 Oty Registered 6ectrician - Thermal MUST
fist Oty 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.
01
Applicant:
Print Name. Jon Carlson Signature Date 1118/17