HomeMy WebLinkAbout508 JANSEN DR - APPLICATIONS - 6/10/2013(city of
Fort Collins
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 # Date
For offs us on
Job Site Address (required) Value of Construction (labor, materials, profit)
5oS fir- 24 , la"
Property Owner Name Address City/State Zip Phone
prnnn I Ccsnqntz SoR N For� (Alin $051S 476 h41-_rA
Applicant Name Address City/State Zip Phone
Duew U1 A+E'IhZc2�" Li-o E 7(L- Ave D�nvet ( 0 Rw 1z (i20) 3i8- 60
Solar Contractor License #/Co. Name Address City/State Zip Phone
•� - E -70L Lve v f to 02.2 4
Contractor Cityof 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�EEN PRE -APPROVED BY CITY LIGHT AND POWER? ❑ 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 If yes, you may need to contact Historic Preservation
Description of work*
*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)
ri drician Plumber
Roofer (For solar PV shingles)
e
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: CF_^f�
Print Name: rl �1 i.i 6nk, cr-� Signature Date