HomeMy WebLinkAbout3858 CENTURY DR - APPLICATIONS - 3/21/2017Planning, Development and Transportation
City of Building Services Department
281 N. College Ave P.O. Box 580
F61ram} ` 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):
B Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # I� Date 3/21/2017
For ofce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3858 Century Drive
$6600
Property Owner Name Address
City/State Zip
Phone
Paul Thayer 3858 Century Drive
Fort Collins CO 80526
970-420-7789
Applicant Name Address
City/State Zip
Phone
Matt Scherer- GraySlone Solar 5644 Cardinal Flower
Court Fort Collins, CO 80528
970-988-5682
Solar Contractor License #/Co. Name Address
City/State Zip
Phone
S-3657 / GraySlone Solar 5644 Cardinal Flower Court Fort Collins CO 80528
970-988-5682
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? 8
Here ❑ Report
Sales tax number & required by all contractors.
Are you paying with your trust account? ❑
Yes ❑y No
00134821
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? O Yes
Is this a residential or commercial project? 8 Residential ❑ Commercial
If residential, is it: B 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 SO years of age or more? ❑ Yes B No If yes, you may need to contact Historic Preservatior
❑ No
Description of work*
Installation of 2.9kW roof mounted, flush mount PV system- grid tied. 10 panels total.
*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-1407 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 3/2112017