HomeMy WebLinkAbout1405 Teakwood Dr - Applications/Solar - 05/16/2019Planning, 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):
® Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Zl 0 03
For office use only
Date 4/30/19
Job Site Address (required)
Value of Construction (labor, materials, profit)
1405 Teakwood Drive, Fort Collins, Colorado 80525
9715.00
Property Owner Name Address
City/State Zip
Phone
Michael and Jennifer Lodato 1405 Teakwood Drive, Fort Collins, CO 80525
970 901-9873
Applicant Name Address
City/State Zip
Phone
Ashley Lanham 3250 N 750 E
Layton, UT 84041
385 415-9655
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S-3758 EMDire Solar Group3250 N 750 E
Layton, UT
385 415-9655
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 ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? M Yes ❑ No
Is this a residential or commercial project? ® 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 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to contact Historic Preservation
Description of work*
To install a 7.04kW roof mounted PV array using 22 Silfab 320 panels and a SolarEdge 6000H-US inverter
*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 ME-1602 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: Ashley Lanham Signature .CQ LfLlilNi Date 4/30/19