HomeMy WebLinkAbout3615 Big Dipper Dr - Applications/Solar - 09/29/2018City of
Fort Collins
Planning, Development and Transportation
Building Services Department
281 N. College Ave P.O. Box 580
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):
B Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application� —I Date # 81 Date 9n9n8
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3615 Big Dipper Drive
$10,080
Property Owner Name Address
City/State Zip
Phone
Rebecca Avery 3615 Big Dipper Drive
CO 80528
970-213-0020
Applicant Name Address
City/State Zip
Phone
Matt Scherer- REenergizeCO 418 South Howes STE 102 Fort Collins CO 80521
970-988-5682
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S-3657 / REenergizeCO 1791 East 58th Ave. Unit B, Denver, CO 80 970-988-5682
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
@ Here ❑ Report
Sales tax number Is required by all contractors.
Are you paying with your trust account?
❑ Yes ❑� No
00134821
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? O Yes
Is this a residential or commercial project? 8 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 more? ❑ Yes 19 No If yes, you may need to contact Historic Preservation
❑ No
Description of work*
Installation of 5.04 kW roof mounted, flush mount PV system- grid tied. 14 panels total, no batteries
*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 ME-1556 (First Response) 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: Matt Scherer Signature Date 9/29/2018
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