HomeMy WebLinkAbout902 E Stuart St - Affidavits/Homeowner - 08/31/2010City of Planning, Deveiopment.and Transportation
'} PC -Box 58a
E195�. �` Cottin� 281 N Eogege Ave
F Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 faz
V,Ne, q SHb?-( 6V"' 13 WL as cwner(s) of recard'of the property located
At 1, ��— ��' S �� 5 I _ Fort Collins, -Colorado, hereby declare and attest
I
o the following: (plegse check only the one that applies)
❑ 1 am/ we are acting on my/ our behalf for the purpcee:of obtaining a building; permit and personally
constructing my/cur home. The home to be constructed is on tte above property and wilfbe my/cur
primary residence. Vwe have nct.personalfy construC,ed nay other new homes in the Fort Collins
city limits within the past 24-month perfcd.
I am/we are acting on my/our behalf for the purpose of abtalring a building p&rnlf and personally
constructing an alteration or addition to my/cur house. The house to be altered is on the above
property and. is my/our personal residence.
❑ 1 ainhere are acting. on my,/out behaif for fie.pu' ose of, obtaining a building permit and personally
constructing a non-structural alteration to my/our attached single-family dwelling. unit The house
to'be aftered is my/our personal residence. I am:aware.that !/we cannot de any structural,
electrical, plumbing ore mec ianicaf work and must hire cc ntractors/subcontractors who are
currently licensed and insures with the City of Fort Collins.
l arn/we are personally performing all of the work, or will be continuously supervising unpaid volunteers.
The work is directly 8.1114conitiiidan of th"�beve referenced home, which is described more fullon Permit App(icatio �I o (obtained from Building and Zoning office). 1/we
understand that any person(s) or agent(s) contracted to perform structural wced-framing, plumbing, HVAC,
electrical work;466firig or cast-in-place.structural concrete work, MUSTEE licensed contractors in
accordance, with the regulation of the City of Fort Collins.
Uwe 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 Work Order and a court summons:
,
Sign in fhs preserce N;a_r c
Owner \
Co-owner.
The foregoing Affidavit was acknowledged before me on this )1 � day of
c CLOD (J (month, year) by (I L,,
Ylitrress my hand and official seal Wa010040;,;
tuts O. '' •.
My commission expires: o: pYlg `
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Notary Public