HomeMy WebLinkAbout1315 Vinson St - Affidavits/Homeowner - 04/18/2007FROM :NCA
kN-G7-2001')-M0v 12.42 PM
FAX NO. :9702299993 Apr. 18 2007 08:23AM P5
P, Q9PHI
City of Fort Collins
Community Planning and Environmental Services
Building and Zoning DepartmenF
13o
HOMEOWNER/BUILDER AFFIDAVIT
I/we, a 0,.__ as owner(s) of record of the property located
(please print)
at: V P Ct Fort Collins, Colorado, hereby declare and attest to
(please print) .
the following; (pleasF check A, 6 or r wh/chever app%ies)
o A. I am/ we are acting on my/our behalf for the purpose of obtalriing a building permit and
personally constructing my/our home. The home to be constructed Is on the above property and
will be my/our primary residence. I/we have not personally constructed any other new home in Fort
Collins city limits within the past 24-month period.
• B. I am/we are acting 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.
o C. I am/we are acting'on my/our behalf for the purpose of obtaining a building permit and
personally constructing a non-structural alteration to my/our attached single family dwelling.
unit, The home to be altered is our personal .residence. I am aware that I/we cannot do any,
structural; electrical, plumbing or mechanical work and must hire. contractors/subcontractors who
are currently licensed with the City of Fort Collins.
I am/we are personally performing all of the work, or will be continuously supervising unpaid volunteers.
The work is directly related to the construction of the above referenced home, which is described more
fully on Permit Application # (obtained from_Building and Zoning
Office). , I/we understand that any persons or -agents. contracted to perform structural wood -framing,
plumbing, 4VAC, 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.
I/we understand that failure to comply with any of the above conditions may result in revocation of
any permits associated with the above Permit Application number, forfelture of any fees that have been
collected, a Stop Work Order and a court summons.
Sign in the'o ante of a Notary Pubilc
� � I A 1'
-- Owner
The foregoing Affidavit was acknowledged before meson this 1 day of
witness my hand and official seal r ?R,
'NOq��:p�
My commission expires: = J=
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281 North College Avenue - PO. Box 580 • r-ort Collins; CO 80522r0580
22T6760 - FAX (970) 224-6134