HomeMy WebLinkAbout225 Green Leaf St - Applications/Solar - 10/27/2016 (9)Fort Collins
Planning, Development and Transportation -4ri
Building services Department
281 N. College Ave P.O. Box 580
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) (79
❑ Thermal Solar (Hot Water System) T
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # e? 1 b o U y Date 10 /V
For olhce use only
Job Site Address (required))
Value of Construction (labor, materials, profit)
225 Green Leaf Street 3 , Fort Collins
CO 80524 7568.4
Property Owner Name
Address City/State Zip Phone
New Home Lot 1 L Block 4
Same as above N/A
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
1 470 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 isrequ/red byall 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 may need to contact Historic Preservation
O No
Description of work*
Install a 5.565 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 Solar City I
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, DpWiy:renea by Corn Bmslew
PP , Colin Binsfeld Colin Binsfeld Oale:2016.10.241043:35 10/24/2016
Print Name: Signature -0roo• Date