HomeMy WebLinkAbout1007 Stonecrop St - Applications/Solar - 07/18/2018Fort Collins
Planning, Development and Transportation
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):
FX Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Date ` a
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
1007 Stonecrop Ct, Fort Collins, CO 80526 4862
Property Owner Name
Address City/State Zip Phone
Ashley Gagne
Same as above 304-549-0923
Applicant Name
Address City/State Zip Phone
Tesla Inc. /Solar City
470 E 76th Ave #3A Denver, CO 80229 253-720-4461
Solar Contractor License #/Co. Name
Address. City/State ' Zip Phone
Tesla Inc. /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 tax number is required by all contractors.
Are you paying with your trust account? ❑ Yes QX No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Ox Yes
Is this a residential or commercial project? OX 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 Ifyes, you mayneed to contactHistorlc Preservation
❑ No
Description of work*
Install a 3.575 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 CityRegistered Electrician — Thermal MUST
list City Registered Plumber)
Electrician SolarClty 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: Daniel Licciardello DlgitaAysigned Dy DaNel
Print Name: Signature Daniel Licciardello ueQamela Date 7/16/2018
Date: 2018.07.1613:i956-06'00