HomeMy WebLinkAbout613 MEADOW RUN DR - APPLICATIONS - 12/23/2015Planning, Development and Transportation
City of Building Services Department
■ 281 N. College Ave P.O. Box 580
Fort 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 # �� ����Lt� Date
For o>fce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
613 I'H.ts dow Rv.n
A 1R 0130
Property Owner Name Address
City/State Zip Phone
Ve;+I. rcpe�;J% `I Re"w 9,., rl. 6o11rns 60 905zl' (9-7,0211-07o
Applicant Name Address
City/State Zip Phone
P, it S to-Avw w 11ov 6*. Sr"�Ahr
�>Aw, Lv 80138 C 9yv7�rS�G -!v1 y
Solar Contractor License #/Co. Name Address
City/State Zip Phone
5-25YS'-PV Svoifalk 561" llboE
51'0-,4vt be�qv-W & 8bZ38 i303)9oy-27V
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? X Here ❑ Report
Sales tax number is required by all contractors
52Yo9
Are you paying with your trust account? ❑ Yes No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? X Yes CI No
Is this a residential or commercial project? 14 Residential ❑ Commercial
If residential, is it: 39 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 A No If yes, you may need to contact Historic Preservation
*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: ! o L/� �ji 2 2 3
Print Name: � . l Tk0 Signature • Date i Ir