HomeMy WebLinkAbout1304 Lory St - Applications/Solar - 06/13/2019Planning, Development and Transportation
FCity of
®it Collins
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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):
Photovoltaic Solar (PV) ;
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accep£ed.
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Application # q U Date �
For otirie u e only
Job Site Address (required)
Value of Con ruction (labor, materials, profit)
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Property Owne Name
Address
City/State
Zip
Phone
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a 60111neco
5052 ^720 - 6 —
Applicant Name
Address
City/State
Zip -
Phone
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$5 5, eL'WG Pkwy.
S`IF. S03 Cef
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20-61 -7�
ctor License #/Co. Name
Address
City/State
Zip
Phone
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Contractor City of Ft. Ilins Sales
ax #
Are you paying taxes here or by report? X Here
❑ Report
sales j er1 3uir by all mnbadois
Are you paying with your trust account? ❑ Yes
)CNo
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? O Yes O No
Is this a residential or commercial project? X Residential ❑ Commercial
If residential, is it: XSingle 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? k(Yes ❑ No
If yes, you may need to contact Historic Preservation
Description of work* l l f
kU �[u.S(7 roC'F Mov�>7"I Solar �V S �bST2m�
12 0 ane, 5
*Please note in description if; roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels.
Subcontractors: list the mmpany name or City of Ft Collins license # (PV MUST list City Registered Elecfridan — Thermal MUST
list City Registered Plumber)
Sectridan 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: r ��//
Print Name: L 0 7 rti"I � 0', Y<ignature Date D 5 0 3