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HomeMy WebLinkAbout5410 Apple Dr - Affidavits/Homeowner - 10/09/2013//_++,,iTV Or Plannin; De� elccnsnt and T ransperia"ar. � i�7 L �V ins 'O. 30XI580 -�, Coil_=2e 4: 011MEOWNEER AFFIDAVIT I/we, �o r ?10 ::e -,as owner(s) of record of the property located At: Fort Collins, Colorado. hereby deolare and attest -— -- to the following: (please check only the one that applies) ❑ 1 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. I/we 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. 1 am/we are acting on my/our behalf for'the purpose of obtaining a bui:, ea 7-rmit and personally constructing a non-structural alteration to my/our attached single family i� F, ;,•� unit. The house to be altered is my/our personal residence. I am aware that I/we cannot do•ar; '% electrical; plumbing ore mechanical work and must hire contractors/subcontractui, co ,.' currently licensed and insures with the City of Fort Collins. I 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 r (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 in %:; Public ©� Co-owner The foregoing Affidavit was acknowledged before me o�n, this —�}-� day of (month, year) by Witness my asl0-and 6Ii al My corn t wnuexpires: r 'C® Notary