HomeMy WebLinkAbout640 Endicott St - Applications/Solar - 12/04/2019Planning, Development and Transportation
City of Building Services Department
281 N. College Ave P.O. Box 580
01r}} ` 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):
0 Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # (MAI b2i 2Z Date
For ofca use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name Address
City/State Zip
Phone
2
b z1 3
Applit4nt Name Address
City/State Zip
Phone
EcoMark Sales, INC. 4665 Paris st, # 300-C
Denver, CO 80239
720-919-0261
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
#3918-5 #53747 EcoMark Sales INC. 4655 Paris st #300-C Denver/CO 80239
720-432-6411
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
V Here ❑ Report
Sales tax number is required by allconbactors
Are you paying with your trust account?
❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? N(Yes ❑ No
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: EtSingle 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 WNo If yes, you may need to contact Historic Preservation
�escription of work* pya76� kWDC Rooftop, Flush -mounted, PV Solar system, Utility interconnected, 7 Modules
*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)
Electridan 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: t
Print Name: Chris Gibney Signature td Date