HomeMy WebLinkAbout122 3rd St - Applications/Solar - 04/01/2019Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
FOIr•} ` Collins 1S 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 # :b / "/ V
For office use only
Date 4 I ( Ir-)01 9
24, 45 Ip . q4 . va ( t,,GLhDlti
Job Site Address (required)
Value of Construction (labor materials, profit)
'b'�G53'4
M - (bcttl aM
122-0 3►'d St. } Coll LV►S C.0 . 0toa-11 3-.35
Property Owner Name
6IDT7,ie'5
Address City/State Zip Phone
w 1 oarn av& VV6"�ylS1-fAq Co 6031 1J6 qq (4 0
Applicant Name
Address �� � ( 1;itv/Sta�lw�S�� w-orco 6091
CJC7�Yl
Pl�6fiori 131ti11'2er�Jl
844-727-6527
Solar Contractor License #/Co. Name
Address City/State Zip Phone
844-727-6527
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account? ❑ Yes 5a No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ Yes ❑ No
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: Q3ingle 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 �ONo If yes, you may need to contact HistoncPreservat/on
Description of work*
6-301 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 r 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: Print Name:ft1rG/.a�Signaturc�(_Q _ 1 -Date~