HomeMy WebLinkAbout3307 Pepperwood Ln - Applications/Solar - 11/26/2018Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
'6rl} 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 # -b I
For office use only
�2,p
Date
Job Site Address (required)
Value of Construction (labor, materials, profit)
3307 Pepperwood Ln, Fort Collins,
CO 80525 20740
Property Owner Name
Address City/State Zip Phone
Michael Fink
Same as above 970-310-8142
Applicant Name
Address City/State Zip Phone
Tesla Energy Operations Inc.
470 E 76th Ave #3A Denver, CO 80229 (253)720-4461
Solar Contractor License #/Co. Name
Address City/State Zip Phone
Tesla Energy Operations Inc.
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 mayneed to contact Historic Preservatior,
❑ No
Description of work*
Install a 15.25 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 Testa energy operations Inc. 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 Danny Licclardell0 Lic6altysigned by Dankl
Daniel Licciardello [Ft. 018 11/21/2018
Print Name: Signature �a,a:zo,a.,,.z,oa:aas.-0roo Date