HomeMy WebLinkAbout5726 Big Canyon Dr - Applications/Solar - 01/11/2017Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
/.F6r } ` 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 # B 17 0 0141 Date
For ofce use only
ENTERED JAN 112017
Job Site Address (required)
Value of Construction (labor, materials, profit)
5726 Big Canyon Drive, Fort Collins CO 80528 9424.8
Property Owner Name
Address City/State Zip Phone
John R Weeks
Same as above (970) 372-7760
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? OHere ❑ Report
Sales tax number is required by all 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? E] Yes O No
Is this a residential or commercial project? OResidential ❑ Commercial
If residential, is it: Nsingle 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 6.93 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 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, o eezoipnWb 3em Buft
Print Name: Jeremy Burks Signature Jeremy Burks DWw Date 1 /4/2017