HomeMy WebLinkAbout901 QUEENS CT - APPLICATIONS - 1/23/2018Fort Collins
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)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # e)I Aon534- Date 1/23/2018
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
901 Queens Court
17,000
Property Owner Name
Address City/State Zip
Phone
Thomas Andersen 901 Queens Court Fort Collins 80525 - cj —3J 9
Applicant Name
Address City/State Zip
Phone
Sandbox Solar
430 N. College Ave Fort Collins, CO 80524
970-673-7733
Solar Contractor License #/Co. Name
Address City/State Zip
Phone
S
430 N. College Ave Fort Collins, CO 80524
970-673-7733
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
1A Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes IR No
27948818-0000
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? 0 Yes 0 No
Is this a residential or commercial project? 1R 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 DQ No
If yes, you may need to contact Historic Preservation
Description of work*
7.0 M Rooftop Flushmount Grid Tied Photovoltaic System
*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 0 (PV MUST fist City Registered E/ectridan — Thermal MUST
list City Registered Plumber)
Electrician Triple G Electric 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. �o,q
Applicant: Ian Skor C��i �'
Print Name: Signature Date 1/23/2018