HomeMy WebLinkAbout1826 Silvergate Rd - Affidavits/Homeowner - 11/06/2008City of Fort Collins
Cornmunity Planning and Environmental Services
Buildin` and Zoning Depar"unent
HOMEOWNER/BUILDER AFFIDAVIT
0806
`.
I/we,�� �Q I e as cwner(s) of record of the property Iccst_c'
(please prim
at otr , Fort Collins, Colorado, her=tV dECICrc and att:st o
(pie=sa prim
the following: A, E7 CS C, WlilCi`iE'/e' c,�Dllr=�j'
c A. I am/ we are acting on my/cur behalf for the purpose.cf obtaining a building per-init and
personally constructinc 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.
E. I am/we are actfnc an my/our behalf for the purpose cf 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.
e C. I am/we are act irc or, my/cur 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. 12[7, aware that I/we cannot do any
structural, e!ectrical, plumbing or mechlanicsl work and must hire contractors/subcontractors who
are curer ent'y licensed with the City of Fort Collins.
I am/we are personally performing all of the work, or will. be continuously supervising unpaid volunteers.
T r e work is directly related to the cOnsti uctiCn of t e above referenced. home, which i5 deSCr 1bEd more
f.:liy on Permit Application � (obtained from Building and Zoning
Gf Ic=). I/we undErst_nd that any persons or agents contracted to perform structural wood -framing,
plum;ling, HVAC, Electrical work, rccrinc or c=st-in-place structural concrete. work, MUST BE licensed
contractors in accordant_ with � the reculaticn of the City of Fort Collins.
I/we understand that failure to eornpiy with any of the above conditions may result in revocation of
any permits asscclated with t e above Permit Applic tier, r;umber, fOrfc!ture cf any fees that have been
collected, a Stop Work Order and a court summons.
5ig;, in t`e Frew^,c_ cfa Icterl Public
I
j Owne:
Owner
The fu-rcccinc Ai i idaV!t �VcS El' `r/IE:iged before r e on this da` Gf
�r� r�rt�, yEar)by '
VVitness my hand a^dk� 1c'14Q ?,q ;
My ccmm,-s cn
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Co o,,..�1�:L Notary Pub
4PIRES
'El _,,. Ce z- r..z Box Sou Cclns, CO 8G3_i_-n-cl . (9-0)='1-6760 ^ FA-X (970) 21 !-61-'
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