HomeMy WebLinkAbout901 GROUSE CIR - APPLICATIONS - 2/25/2014City of
F6rt Collins
3 sc� Co
Planning, 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)
e
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # 514010 21, Date
For office use only
Job Site Address (required)
V lue of Construction (labor, materials, profit)
'101 G ro a Se Cir
l aa0
Property Owner Name
Address City/State Zip
Phone
Shonno, Keyno-ter Same, os abo\/e Fo (o Tins 8oaq
976-q30-16K),
Applicant Name
Address City/State Zip
Phone
I o Ni�C K�oE
ve-W 0 80
E>YI-610-5930
Solar Contractor License #/Co. Name
Address City/State Zip
Phone
So) C:
Sow f, as above,
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 XNo
IF SOLAR PV SYSTEM, HAS THE PROJEC�EEN PRE -APPROVED BY CITY LIGHT AND POWER? KYes ❑ 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* tns+allaat-n iooff' ar/A-+iectf. PV susfem -Plush YnOU P-A t/�
o roof-
40
kv✓
*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:
Print Name: Signature �l-+arlA'�i�� e Date �l�