HomeMy WebLinkAbout420 RIDDLE DR - APPLICATIONS - 5/14/2018Planning, Development and Transportation
City Of Building Services Department
6r►t - 281 N College Ave P O Box 580
1 l Coi1 IS 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)
FX Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application Incomplete applications will not be accepted
Application #
?) I q) b 3 to n c) Date 5 l I` h 00
For ofce use only
Job Site Address (requved)
Value of Construction (labor, materials, profit)
420 Riddle Dr, Fort collins, CO 80521 74664
Property Owner Name
Address City/State Zip Phone
Wally Vansickle
Same as above (970) 420-5084
Applicant Name
Address City/State Zip Phone
Tesla Inc /Solar City
470 E 76th Ave #3A Denver, CO 80229 253-720-4461
Solar Contractor License #/Co Name
Address City/State Zip Phone
Tesla Inc /Solar City
470 E 76th Ave #3A Denver, CO 80229 253-720-4461
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑X Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account? ❑ Yes ❑X No
IF SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY CITY LIGHT AND POWER? Qx Yes ❑ No
Is this a residential or commercial project? ❑- Residential ❑ Commercial
If residential, is it QSingle 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 ❑ No If yes, you mayneed to contact HistoncPreservation
Description of work*
Install a 5 49 kW roof -mounted grid -tied solar PV 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 Coffins license # (PV MUST list 0-ty Registered Elednaan - Thermal MUST
fist Oty Registered Plumber)
Electrician SolarCity 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 Justin Catlett
Print Name
Justin Catlett D,,dally signed by Justin Catlett
Date 2018 05 1412 02 11 5/ 1 4/201 8
Signature -woo Date