HomeMy WebLinkAbout509 Duke Ln - Applications/Solar - 02/26/2020Planning, Development and Transportation
City. of Building Services Department
281 N. College Ave P.O. Box 580
FF6rtCollins 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 # NO M U Z�� Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
509 Duke Lane Fort Collins, CO 80525
$17,000.00
Property Owner Name Address
City/State Zip
Phone
Thomas Stermitz 509 Duke Lane
Fort Collins, CO 80525
303-725-5963
Applicant Name Address
City/State Zip
Phone
EcoMark Sales Inc. 4665 Paris St. #300-C Denver, CO 80239
720432-6411
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S-3747 EcoMark Sales Inc 4665 Paris St.
#300-C Denver, CO 80239
720432-6411
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
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? *XYes
Is this a residential or commercial project? &Residential ❑ Commercial
If residential, is it: aSingle 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 4/No Ifyes, you may need to contact Historic Preservation
O No
Description of work*
3.65kW Rooftop, Flush Mounted, Utility Interconnected, 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 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: Taylor Cordone ��� 2/26/2020
Print Name: Signature Date