HomeMy WebLinkAbout5232 Fox Hills Dr - Applications/Solar - 11/23/2016Planning, Development and Transportation
City Of Building Services Department n C�7
281 N. College Ave P.O. Box 580 f r*
For} ` 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 # � I ',t / dU
For olhce use only \,
Date �3do
Job Site Address (required)
Value of Construction (labor, materials, profit)
5232 Fox Hills Dr, Fort Collins CO 80526 7425.6
Property Owner Name
Address City/State Zip Phone
Peter Parnegg
Same as above (505) 280-4333
Applicant Name
Address City/State Zip Phone
Solar City
470 E 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 tar number is required by allmntractars.
Are you paying with your trust account? ❑ Yes ❑X No
1
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? H Yes ❑ No
Is this a residential or commercial project? QResidential ❑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 may need to contact'Historic Preservation
Description of work*
Install a 5.46 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 Cityof Ft Collins license # (PV MUST list 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, DpWl,.goon W e ,, .n
pP , Benjamin Smythe Benjamin Smythe �yte 11/21/2016
Print Name: Signature Die: M16. 11.21 07.W27 -0P Date