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HomeMy WebLinkAbout2703 Canby Way - Affidavits/Homeowner - 04/17/2007L" fMIII IaYIIt�t; y1']ELIII i.,n�'ril ._ e.� � s j � r{Gf✓ UZLD�r. a r FZC G.t ui I/10 �VJP�✓ 3��Co �` UV✓nc'r(�) OT I"orr71 OT tll_ pl"Dpef L)i OCdted ( pLasc prmt;) FDo t Collins, Colorado, hereby declare and attest to. th]efollov'ling: D/'C )wi�ich?I�a,�apoli�_) U_ I am/ we are a� tinq on my/our behal' for th'-�� purpose of obtaining a_ building permit and personally construfting my/our home,. The home to be construrted is on the above proper-tj- arld Will be my/our primer>> residence. Ijwe have not personall�� constru ted an�� oth'er new home ire Fort Collins cite limits within the past 24-month period. E. I am/we are aging on my/our behalf for the purpose of obtaining a building permit and personally constructing an alteration or addition to my/our home. The home to be altered is on the above property and is my/our personal residence. ❑ C. i am/we are aftinq on my/our behalf for the purpose of obtaining building permit and personally constructing a non-structural alteration to my/our al-ta—Zhed single sarniiy dwelling unit. The home to be altered` is my personal r esldence. I am aware that llwe cannot do env stru tural, electrical, plumbing, or mechanical wort and nnust hire contrators/subcontractors who are currentiy licensed with the Cit)/ of Fort Collins. i am/we are personally Dellormino all of the work, or VVill be ContlnuDIJSly SuPerVlSing unpaid volume--rS. a e e ad home vvhi h is described The work is directly related to the construction of the above r_� r�nc more fully on Permit Application C)? © a 33) (obtained from Building and Zoning Office). 1/we understand that any persons or agents contracted to perrorrn structural wood -framing, plumbing, HVAC, electrical work, roofing or cast -in -place structural concrete work, MUST BE licensed contractors in accordance with the regulation of the City of Fort Collins. 11, i/we understand that failure o compty �n,ith any of the above conditions may. result in revocation of any permits associated with the above Permit Application number, forfeiture of any fees that have been collected, a Stop Worl: Order and a court summons. 13 O O 3 Sign in the presence or a Notar Public 7 23 Owner 77 ner The foregoirUqIIVRs. acknowledged before me on this 11 day of (month, year)by _ �UPe\n sohh (�i vv�=r1 Witness m*,an�and o cia{ S29„F 1y Comm;ex* Notary Public 11V0].[h Colhi,E �,� e]1L12 PO. ja,. Sri(! ° P0;.1. r'C;lIms, CC) C,0 )''` 4380 ' (970) 12.1-D