HomeMy WebLinkAbout3024 Cortez St - Applications/Solar - 04/10/2020Planning, Development and Transportation
GI Of Building Services Department
Fort Collins N. College Ave P.O. Box 580
For
Fort 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):
9 Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Date �r a — ��
For ofce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
" U o� Z , 4 Fri
1(\ o 0s 5
1q, 6 00
Property Owner Name Address
City/State Zip
Phone
r sn< a . k
. sE..6-;r F C,t la,5, q
65),5 q 70-
Applicant Name Address
City/State Zip
Phone
Frew\,r-r'�- LS
S1. 60 qQ35
7)0-YP-4y4)
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
1 q -S d (A I« 'eioh-o,,-,'�k.
N5 A, -Es 5), lda3y
Tao 591- 5 115
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? 0 Here ❑ Report
Sales t u, b>/s�uirp<{bySanntrsctors.
b
Are you paying with your trust account? ❑Yes ElNo
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? &[ Yes ❑ No
Is this a residential or commercial project? 4Y 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 d1l No /fyes, you may need to contact Historic Preservation
Description of wprk*
k-W J`ooFiat, \uSL,��t�v�•, (1 V t\t1-\cG�r�=c f
5y5:hc� _ <� ., a� .�' Q �c. I -es o.,ci o��ti.r,
'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 //st City Registered Electrician — Thermal MUST
list City Registered Plumber)
umber)
Electrlcian �7-T [ 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: � (S `�
Print Name:�"i FI kN1�t � -A i r,., i5- Signature Date _ � — ot0
2�0 - - 6-735
1?5c 3