HomeMy WebLinkAbout856 Ridge Runner Dr - Applications/Solar - 11/23/2016Planning, Development and Transportation
City �}Of Building Services Department281 N. Coege Ave
3 �
FOI1` Collins r1 IS Fort Co I ns, CO 80524 P.O. Box 580
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):
QX Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # �-1 I
For office use only
Date/l l6
Job Site Address (required)
Value of Construction (labor, materials, profit)
856 Ridge Runner Dr, Fort Collins CO 80524 4950.4
Property Owner Name
Address City/State Zip Phone
Stephen S. Rosenberg
Same as above (970) 590-6885
Applicant Name
Address City/State Zip Phone
Solar City
470E 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 isrequlredbyall 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 ONO
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
Is thist`tiuilding
❑ Restaurant ❑ Other (explain)
50 years of age or more? ❑ Yes ❑ No
If yes, you may need to contact Historic Preservation
Description of work*
Install a 3.64 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 # (PitMUST iist City Registered Electrician — 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: D9 W, agW Dy Dvp.n
Print Name: Benjamin Smythe Signature Benjamin Smythe �a Date 11/17/2016
Dab, 2015.11, 17 1315 35-OTW