HomeMy WebLinkAbout1012 Sycamore St - Affidavits/Homeowner - 02/27/2014� y
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ri of fl o nrnnnHw it nnfmIl t
,Fort Collins, Colorado h`erebv de .1 rP anti attPet
to the following= -(please check`only'the:;one that applies) �t�
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❑ .I am/ we are acting on my our
behalf for the purpose of -obtaining a building permit and personally
constructing myLour home The home to be constructed is on the above property and will be my/ou`r
pnmarylresiden,ce I/weve not personally constructed n`ay other new homes in the Fort Collins
city limits within the pasf 24 month period.
am/we. are acting on my}/our behalf for'the purpose of obtairnng a budding 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
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we are acting on my/our behalf for the purpose of obtaining a budding permit and personally
constructing a non'struetural alteration to my/our attached single family tlwellmg umt` The house
pt to be altered is my/our personal re�iderice I am aware, that I/vie c�,�i;ot do any''suucuial,
electrical, plumbirig orIII e, mecII.hanical work ar,d must hire contractors/subcontractors who are
currently licensed and insureslwith the City of Fort Collins '
i i , it ,.� , j'. {',J I n ^ � i Y ls� I `. ,
T�r Et' s �Y
I, am/ we`are personally performing all -of the work orV.
will be continuously supervisiing'unpayd volunteers a
The work is directly related to the construction of the above referenced home, which is described more fully
on Pefmit A lication f (obtamed,from Building and Zoriing office) I/we
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understand that�any person(s),or age`nt(s) contracted to perform strructural wood framing; plumbing, HUAC, .
electrical work; roofing or cast in place -structural concrete -work, MUST'BE licensed.contractors in, '
accordance with the regulation bf the City of Fort Collwns`
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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+thatLhave been,
collected a Sto''p Word' er and a court summons • ,`
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Shin in the pres e of Not` Pu tic''
} O�meF Go owner
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The foregoing Affidavit;was acknowledged before me on this �� 'da of
T3 '^^, y
` t� (month, yeareq
ff
Yet
Witness my hand and ofncial seal'MAR OARET R CLANCY „ a
Y NOTARY.P.USLIC `'
STATE';OF COLORADO + i
My commissiori expires' fY'; ,� NOTARYIID #•201340'40425 _ s
` - - MV COMMISSION EXPIRES AUGUST OB 2017 + '
NotarylPubl i+l
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