HomeMy WebLinkAbout2200 Airway Ave - Affidavits/Owner Agent - 01/03/2007Comr unit% Planning and Environn��mneen----tal Services
Building and mooning Department w ��i (fl O
3UILDINtG, OWNER /AGENT AFFIDAVIT
JCCity of Fort Collins
Uwe gyp- ' �1)' as owner(s) of record of the property locatad
n Colorado hereb declare and attest o the following:
aI - __, Fort Colli, s, , y g
(please checR the box that applies)
1 am/we are acting on mybur behalf for tile purpose of obtaining a building perms: for minor alterations to the
building referenced above. I am/we are personally performing all of the work as allow_,d by City of Fort Collins
code and as approved on parnit� I Urlder5'a L sat ail VVUPk feinted to electr l al,
plumbing, HVAC, gas piping and fire extinguishing systems must be performed by a City of Fort Cc'.Ilns
licensed subcontractor and that Sus work cannot commence until the City of Fort Collins Building & Zoning
department is notified of the subcontract:--r. '
I/we am/are personally acting as the General Contractor for the purpose of obtaining building permit
# 3o6 o S`t �� for minor alterations to the building referenced above. I know that the labor, material
and profit of the permit cannot exceed $5,000, 1 understand that all work related to electrical, plumbing,
HVAC, gas piping and fire extinguishingsystems must be performed by a City of Fort Collins licensed
subcontractor and that this work cannot commence until the City of Fort Collins Building & Zoning department is
notified of the subcontractor.
[] I/we do authorize (Agent) to act on my/our behalf for the purpose of
obtaining a building permit for minor alterations (no structural alterations) to the building referenced above.
Said agent will be personally performing all of the work as approved on permit #_ I
understand that all work related to electrical, plumbing, HVAC, gas piping and fire extinguishing systems
must performed by a City of Fort Collins licensed subcontractor and that this work cannot commence until the
City of Fort Collins Building & Zoning department is notified of the subcontractor.
' I/4JE UnderStanO 'tndL the hgentnamc'❑ abOb'E IS nuL a contractor and is rlly/u::, SS LIGItI 1.... y l/U:'JIQJ✓
law; or is acting on my/our behalf without any fee, compensation, or trade in -kind no.- the move woo k.
Further, I/we understand that payment of such fees or compensation for the above work; to any person who is not .
in my/our employ as described by Corrado law, constitutes a "construction contract and viola es the Contraclor
License pruvlsjoi IJ o1 -Lie `�i l rill' i ..: .� C.i�� Y.:I ILJ 'I- In -,-V1 ''CZ. :gin a71LV nip , r-_ ,.. , ?rlri �.ri`ir J. ?,^.3s Ord
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a 'court summons. .
Sian in the Pr nce of I aryPublic
Own. r II owner
Agent —
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• N O tqA by
Witness m'a hand and orlcinl seal •F
My commission expire--: ��• '
%/1 _C;to/D COLOaQ� Notary P, li