HomeMy WebLinkAbout415 RIDDLE DR - APPLICATIONS - 1/14/2014Planning, Development and Transportation
City of Building Services Department
281 N. College Ave P.O. Box 580
F®tp� t Collins 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 # 51�00/s3 Date +* � NZO
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
#
L415 AAAleDr
1 0
Property Owner Name
Address
City/State Zip
Phone
c Uikks 54Me, 06 o,bo\/
Fo +Co Tins 805
970— o-1608
Applicant Name
Address
City/State Zip
Phone
1 o Nix K?OE
ve#3
0 80
6vi-610-5934
Solar Contractor License #/Co. Name
Address
City/State Zip
Phone
50)wCaI4
Sorhe os
abovt.
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number isrequlredbyall contractors.
Are you paying with your trust account?
❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJEC�EEN PRE -APPROVED BY CITY LIGHT AND POWER? XYes ❑ 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*
=ns+�,IlAt�on o� aria,'+ieci. PV mowlfe.d to rood'
�9,ga
kw
*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 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: , I
�46/1 Print Name: 1 (°7►'�'1 /V I � Signature �rl��� Date