HomeMy WebLinkAbout6213 SOUTHRIDGE GREENS BLVD - APPLICATIONS - 10/19/2018Planning, Development and Transportation
City Of Building Services Department
/,F6} 281 N. College Ave P.O. Box 580
r`• Co Ins 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):
IN Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # IV I Date 10-19-18
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
6213 Southridge Greens Blvd $15,750
Property Owner Name Address City/State Zip
Phone
Jennifer Mayhew 6213 Southridge Greens Blvd CO 80525
970-817-1879
Applicant Name Address City/State Zip
Phone
Matt Scherer- REenergizeCO 418 South Howes STE 102 Fort Collins CO 80521
970-988-5682
Solar Contractor License #/Co. Name Address City/State Zip
Phone
S-3657 / REenergizeCO 1791 East 58th Ave. Unit B, Denver, CO 80 970-988-5682
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
B Here ❑ Report
sales tax number is required by all contractors. Are you paying with your trust account?
❑ Yes ❑� No
00134821
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? O Yes ❑ No
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: IN 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 9 No If yes, you may need to contact Historic Preservation
Description of work*
Installation of 9.0 kW roof mounted, flush mount PV system- grid tied. 25 panels total, no batteries
*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 ME-1555 (Frstnesponse) 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: Matt Scherer Signature Date 10/19/2018