HomeMy WebLinkAbout303 Green Leaf St - Applications/Solar - 10/27/2017Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
Fort 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):
❑X Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted
Application # EJ V H S
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
303 Green Leaf, Fort Collins, CO 80524 12185.6
Property Owner Name
Address City/State Zip Phone
Tim Boothby
Same as above (979) 580-9611
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? ❑X Residential ❑ Commercial
If residential, is it: QSingle 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 Preservabor
❑ No
Description of work*
Install a 8.96 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 Electrioan — 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: Chris Luther 10/26/2017
Print Name: Signature Date