HomeMy WebLinkAbout3214 Mesa Verde St - Applications/Solar - 06/11/2018Planning, Development and Transportation
City Of Building Services Department
281 N College Ave P O Box 580
Fort 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)
® Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application Incomplete applications will not be accepted
Application # �Date
For ofte use only
6/11 /2018
.lob Site Address (required)
Value of Construction (labor, materials, profit)
3214 Mesa Verde St, Fort Collins, CO 80525 $20,000
Property Owner Name
Address
City/State Zip
Phone
Tim Matthews
3214 Mesa Verde St, Fort Collins, CO 80525
512-963-2411
Applicant Name
Address
City/State Zip
Phone
Sandbox Solar
430 N
College Ave Fort Collins, CO 80524
970-673-7733
Solar Contractor License #/Cc Name
Address
City/State Zip
Phone
S-3665
430 N
College Ave Fort Collins, CO 80524
970-673-7733
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
IA Here ❑ Report
Sales tax number is required by all contactors
Are you paying with your trust account?
❑ Yes 11 No
27948818-0000
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or commercial prolect7 CR Residential ❑ Commercial
If residential, is it ® 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 SO years of age or morel ❑ Yes K No If yes, you may need to contact Hstonc Preservation
Description of work*
6 72kW Rooftop Gnd-Tie Flushmount Photovoltaic System, storage ready inverter
*Please note in description if, roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels
Subcontractors Ust the company name or City of Ft Collins license # (PV MUST list Gty Registered E/ectncian — Thermal MUST
list City Registered Plumber)
SectnaanTnple G Electric 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 Ian Skor
Print Name Signature
Wa-ooz, �S�4.
Date
6/11 /2018