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HomeMy WebLinkAbout3027 Virginia Dale Dr - Applications/Solar - 02/02/2017Planning, Development and Transportation City of Building Services Department I 281 N. College Ave P.O. Box 580 F01rrr���} ` 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 I —I OOy F5 Date For office use only a-a-1-1 Job Site Address (required) Value of Construction (labor, materials, profit) 3027 Virginia Dale Dr, Fort Collins CO 80521 4243.2 Property Owner Name Address City/State Zip Phone Erin Ray Same as above ;. (970) 443-7315 Applicant Name Address . City/State, Zip ' " ' ' Phone Solar City 470 E 76th Ave #3A Denver, CO 80229 253-72074461 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? ©Here O Report sales tax number isrequired byall conbactors. 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? x] Yes O No Is this a residential or commercial project? QX Residential ❑Commercial If residential, is it: E�Single 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 3.12 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, Benjamin Smythe mya4�a by e.ryemm Ben1amin SmYthethe Print S nt Name: Signature NW oe�, mi7,oi.asorzs.isaroa Date 1 /26/2017