HomeMy WebLinkAbout612 SYCAMORE ST - APPLICATIONS - 1/31/2020Planning, Development and Transportation
City Of Building Services Department
281 N. College Ave P.O. Box 580
/+F6r}} ` Collins Fort Collins, CO 80524
'1• Phone 970-416-2740 Fax 224-6134
SOLAR PERMIT APPLICATION FORM
Th's 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 # O) j a 35 Date / % l /a6ab
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
612 Sycamore St Fort Collins, CO 80521
$15,300.00
Property Owner Name Address.
City/State Zip
Phone
Pat Kroutel 612 Sycamore St.
Fort Collins 80521
740-517-4226
Applicant Name Address
City/State Zip
Phone
EcoMark Sales Inc. 4665 Paris St. #300-C Denver, CO 80239
720-432-6411
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S-3747 EcoMark Sales Inc 4665 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?
❑ Here ❑ Report
Sales tax number is requiredby all contractors
Are you paying with your trust account?
❑ Yes ❑ No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? %eYes ❑ No
Is this a residential or commercial project? 9Residential ❑ Commercial
If residential, is it: 4ZSingle 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 Q(No If yes, you may need to contact Historic Preservation
Description of work*
6.1kW Rooftop, Flush Mounted, Utility Interconnected, PV System
*Please note in description if; roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels.
Subcontractors: List fe 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: Taylor Cordone 1/30/20
Print Name: Signature Date