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HomeMy WebLinkAbout219 S Loomis Ave - Affidavits/Homeowner - 09/11/2013Cit./ of Planning, Deve!cpment and i ran<_Por_ation 'Toet Colons PO Sox 580 23I 1�+ Coi(ec,:e Ave 13047 0 1-6750 phci,e 97^-7 L1 fax H©M4 :,OWNER Air 1� III I/we, t ,y';w c AA�6v as owners) of record of the property located r At: c�� �\ SM15 Fort Collins, Colorado. herebv declare and attest to the following: (please check only the one that applies) ❑ I am/ we are acting on my/ our behalf for the purpose of obtaining 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. Uwe have not personally constructed nay other new homes in the Fort Collins city limits within the past 24-month period. 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 house: The house to be altered is on the above property and is my/our personal residence. ❑ 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 house -to be altered is my/our personal residence. I am aware that I/we cannot do any sLl-uctural, electrical, plumbing ore mechanical work and must hire contractors/subcontractors who -are currently licensed and insures with the City of Fort Collins. 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 person(s) or agent(s) contracted to perform 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. 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, forfeiture of any fees that have been collected, a Stop Word Order and a court summons. Sign ' the pr s nce of Notary Public Owner Co-owner The foregoing Affidavit was acknowledged before m/e� on this _/` r� day of �JZ c 13 (month, year) by l �+�t�lS �J�LdA, Q/1lnAou, nY Pr W' Witness my hand and official seal Kp,REN My commission expires: THARP ,1.0 Notary Public MY COMM,ss,oN ExPiRES .i July 23.2015