HomeMy WebLinkAbout313 Leeward Ct - Applications/Solar - 09/17/2019Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO 80524 n ��
Phone 970-416-2740 Fax 224-6134 Y
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 # Q)Iqi�) cri o—A Date
For office use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
Qcn
Property Owner Name
Address City/State Zip Phone
Pace.,
7 3 - -D 1 —
Applicant Name
Address City/State Zip Phone
EcoMark Sales, INC.
4665 Paris st, STE 300-C, Denver, CO 80239 720-919-0261
Solar Contractor License #/Co. Name
Address City/State Zip Phone
S-3747 EcoMark Sales, INC.
720-432-6411
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales fax number is required by all contactors
Are you paying with your trust account? ❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PR03ECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? 0 Yes ❑ No
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: 0 Single Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 0 No If yes, you may need to contact Historic Preservation
❑ Duplex
❑ Retail
Description of work* kW DC, Rooftop, Flush Mounted, PV Solar System. Utility interconnected. Ne.W -SlA15 -Pak RA
Zr'�O /Zf:yC7 A
*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