HomeMy WebLinkAbout216 N College Ave - Affidavits/Owner Agent - 03/29/2013City,Of Community Development & Neighborhood Services
FlirCollins
Fo Box 580 281 N College Ave
/ �Vi-{. " .7 Fort Collins, CO 80522
970.221.6760 Phone 970.224.6134 Fax
BUILDING OWNER AFFIDAVIT
I/we C11 f' l I .16Y VI ( AZt as owner(s) of record of the property
located at Co A) [�P Fort Collins, Colorado, hereby declare and attest to the following:
RESIDENTIAL BUILDING OWNER
❑ This is a residential project, which is not my primary residence, for which the total construction value of all work
including electric, plumbing and mechanical trades does not exceed $5,000 for any one such building or collectively
exceed $10,000 for all such buildings combined within any twelve month period and is considered "Minor Alterations
and Repairs" *(see definition below).
I am acting on my behalf for the purpose of obtaining a building permit for minor alterations to the building referenced above. I
am/we are personally performing all of the work as allowed by City of Fort Collins code and as approved on permit
# . I understand that all work related to electrical, plumbing, HVAC, gas piping and fire
extinguishing systems must be performed by a City of Fort Collins licensed subcontractor and that this work cannot
commence until the City of Fort Collins Neighborhood & Building Services department is notified of the subcontractor.
❑ I understand that I may be asked to provide the City of Fort Collins with a copy of the bids from all
subcontractors that will be involved in any alterations to this project
COMMERCIAL BUILDING OWNER
This is a commercial project for which the total construction value of all work including electric, plumbing and
mechanical trades does not exceed $ 2-000 for any one such building or collectively exceed $10,000 for all such
buildings combined within any twelve month period and is considered "Minor Alterations and Repairs" * (see definition
below).
I am acting on my behalf for the purpose of obtaining a building permit for minor alterations to the building referenced above.
am are personally performing all of the work as allowed by City of Fort Collins code and as approved on permit
# . I know that the labor, material and profit of the permit cannot exceed $5,000. I understand
that all work related to electrical, plumbing, HVAC, gas piping and fire extinguishing systems must be performed by
a City of Fort Collins licensed subcontractor and that this work cannot commence until the City of Fort Collins Neighborhood &
Building Services department is notified of the subcontractor.
❑ I understand that I cannot allow the tenant to do the work for which this permit is issued.
❑ I understand that I may be asked to provide the City of Fort Collins with a copy of the bids from all
subcontractors that will be in volved in any alterations to this project
❑ I understand that payment of fees or compensation for the above work, to any person who is not in my
employ as described by Colorado law, constitutes a "construction contract" and violates the Contractor license
provisions of the Fort Collins Code and will result in revocation of the above permit, forfeiture of fees and a court
summons.
*Definition of Minor Alterations and Repairs - construct, repair or demolish (a) detached structures such as she/ter!, storage
sheds, playhouses, greenhouses and gazebos, and (b) unenclosed structures such as open carports, patio covers, open porches
and decks. Any such work is further limited to one-story building or structures not exceeding two hundred (200) square feet in
floor area and which contain occupancies limited to those classified by the building code as Group R, Division 3, Group 5, Divisions
1 and 2; and Group U other than private garages n
Sign in the presence of a Notary Public
Building
This Affidavit was acknowledged before me on this
Witness my hand and official seal
2 -a`r - 13
Date
by
Name
My commission expires MARCUS GLASGOW_
NOTARY PUBLIC
STATE OF COLORADO Not
ary NOTARY ID # 20124050588 Public
MY COMMISSION EXPIRES AUGUST 22, 2018