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Home My WebLink About913 Kimball Rd - Permits/Other - 01/07/2021City of F6rt Collins Site Address: 913 KIMBALL RD Job Valuation: $2,400.00 Category: Residential Owner: DEMARCO WILLIAM L/CLAUDIA C 913 KIMBALL RD FORT COLLINS, CO 80521 Zoning: Frontsetback: Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134 -fax Building Permit #: B2100116 Issued Full: 01/07/2021 Permit Type: Residential Fireplace Phone: 585-230-7372 Right setback: Left setback: Minor Amend #: Plat File #: ZBA Case #: Zoning district: RL -LOW DENSITY RESIDENTIAL DISTRICT Legal: Subdivision/PUD: Code: Res sq ft: # of stories: Fire Sprklr: Contractor: Rear setback: Filing #: Lot #: Block* Corn sq ft: Ind sq ft: Basement sq ft: Occ Group: Const Type: Stock plan #: Stock plan options: License #: Phone: Supervisor cert#: Subcontractor(s) Phone License Number Work Description: Installation of EPA certified GW1949 US Stove - wood pellet stove. Homeowner affidavit on file. SCHEDULE INSPECTIONS: ** via Text Message: 888-406-6394 ** By Phone: 970-221-6769 ** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mobile Possible Inspections Required: 205 TOTAL FEES PAID AS OF 01/07121: $120.80 Payment method: Credit Card 4070 ** Fee Detail Displayed on Next Page Asa condition for the issuance of a permit, I hereby declare that I am the owner or owners agent, authorized to perform the proposed work on the property described herein. I agree to comply with all the requirements contained herein, and City ordinances, and State laws assodated with such work. I understand that such permit may be revoked in the event that issuance was based on incorrect information. This permit shall become null and void if the work authorized by such permit is not commenced, suspended, abandoned or not inspected within 180 days from the date of such permit. Carbon Monoxide Alarm required within 15 feet of each bedroom entrance. Signature: Print Name: Date: Form Revised Oct 2010 Frt Collins Site Address: 913 KIMBALL RD Job Valuation: $2,400.00 Category: Residential Transactions Method Check Number Date Paid Credit Card CK# 4070 01/07/2021 Receipt issued: 01/07/2021 Total Paid to Date: Fee Description Account Code City Sales/Use Tax 251.122030 County Sales/Use Tax 100.217030 Permit Flat Fee - $65 1000.422010 Amount Paid $120.80 $120.80 Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134 -fax Comments Building Permit #: B2100116 Issued Full: 01/07/2021 Permit Type: Residential Fireplace Fee Amount Amount Paid $46.20 $46.20 $9.60 $9.60 $65.00 $65.00 TOTAL FEES: $120.80 $120.80 Date Paid Amount Due 01/07/2021 $0.00 01/07/2021 $0.00 01/07/2021 $0.00 $0.00 TOTAL BALANCE DUE AS OF 01107/2021: 0.00 Fee Amounts are valid for date of this document only. Fees subject to change without notice. Form Revised Oct 2010 F,`rt Collins Community Development and Neighborhood Services 281 N College buildingservices@fcgov.com Fort Collins, CO 80524 970-416-2740 Application # 1 � I- �y" I " u Date Received I - I - 2c�- ALL information is REQUIRED. Incomplete applications will not be accepted. Job Site Address Address 713 City/State/Zip Fa r l 1 Co I I Iv-5 C-d Property Owner Information Name W lkk iL - Phone Number 6S-'S-i a3 U - 73 7a Address 113 1c:...6OL1i t2 4 City/State/Zip'far+ GlliNs . (0 (Tj ` Single Family Detached QTownhome (attached) Q Duplex QApartment/Condo Garage/Other • Q Bank Q Bar Q Church Q Hotel/Motel Q Medical Office Q Office O Retail O Restaurant Value of Work `L Labor and Materials $ ( 00 Scope of Work (Wood/Pellet stove (required to be EPA approved) Model Name Gc O 1949 Manufacturer V S 5�6Ve O Gas Fireplace Length of extensions of gas line (if necessary) Please list plumber if not completing O Fire Pit Additional Information (if applicable) Contractor Name vjm�c,.. e(Y� Address R k3 L; b. Z rx City/State/Zip Va rA to I I Th s , Co 8(L I Phone Number _K'2 n a'3 0 - -?'3 72 Emailya kk*% v- _de rr%,trc o @ a m..I C 6 P. License Number Certificate Number Subcontractor License (if applicable) Subcontractor Name (if applicable) eV149W, L. ,V c-rcd -t �--� C-1� t/}/2,z r Print Name Signature Date City,of Building Services 580 FoCollins 28 Box N College Ave Fort Collins, CO 80524 970-416-2740 phone 970-224-6134 fax / ! HOMEOWNER AFFIDAVIT I/we, G� r ��i G D e m c.rr a , as owner(s) of record of the property located At: 9/3 kf' t R I( j A Fort Collins, Colorado, hereby declare and attest to the following: (please check only the one that applies): OPTION 1: OPTION 2: OPTION 3: ❑ 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 any other new homes in the Fort Collins city limits within the past 24-month period. UT�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, acting as our own general contractor. The house to be altered is on the above property and is my/our personal Primary residence. ❑ 1 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 prima ry residence. I am aware that I/we cannot do any structural, electrical, plumbing or mechanical work and must hire contractors/subcontractors who are currently licensed and insured with the City of Fort Collins. I am/we are personally performing all of the work or hiring City of Fort Collins licensed trades people, or will be continuously supervising unpaid volunteers (see Option 3 for attached dwellings). The work is directly related to the construction of the above referenced home, which is described more fully on Permit Application # (obtained from the Building Services office). I/we understand that any person(s) or agent(s) contracted to perform structural wood -framing, plumbing, HVAC, electrical or roofing 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 Work Order and potentially a court summons. ,Sign in the presence of Notary Public • Co-owner The foregoing Affidavit was acknowledged before me on this ! ,L� day of n 20 1 (month, year) by l/l�f��iasrt �emat�CO Witness my hand and official seal My commission expires:._ Notary ENotary RINA HARTZOG Notary Public Revised 611012014 tate of Colorado ID # 2 1174008848 ission Expires OY-27-2021 Building Services 281 N. College Ave. P.O. Box 580 Fort Collins, CO 80524 Voice:970.416.2740 FAX:970.224.6134 HOMEOWNER AFFIDAVIT F®rt of Revised 7/7/2014 Homeowners of a DEATCHED single-family home may personally perform and /or act as their own general contractor for any work on their PRIMARY residence. Permit requirements are applicable. If said homeowner hires and pays anyone for work that requires a City licensed contractor, the City licensed contractor needs to be listed on the building permit application, and will need to be current on City license and insurance requirements before the building permit can be issued. Homeowners of an ATTACHED single-family home (townhouse, condominium or duplex), may perform LIMITED "MINOR ALTERATIONS AND REPAIRS" by City Code as follows: "A building owner and any unpaid volunteers or paid workers employed by said owner who perform only minor alterations and repairs to such building, provided that all such work is under the continuous personal supervision of said owner, and further provided that no building owner, or unpaid volunteer or paid worker employed by said owner, may engage in the following types oftvork without obtaining the appropriate contractor license. " Furthermore, the work must be limited to minor alterations and repairs, which, DO NOT include: 1. Any alterations/installations involving, fire -resistive assemblies, alterations to primary and secondary framework; electrical, plumbing, or mechanical systems; and replacement of more than 100 sq. ft. of roofing. PAID WORKERS Regardless of ownership status, said non -owner worker(s) or contractors performing overall project supervision MUST BE A CITY LICENSED GENERAL CONTRACTOR. Any paid specialized trades that perform any one of the following: structural wood framing, roofing, electrical, plumbing, or HVAC, MUST BE SUB -CONTRACTORS licensed by the City. APPLICATIONS & PENALTIES A homeowner acting as their own "general contractor" for work on their own primary residence, must submit a notarized City Homeowner Affidavit form to Building Services before a building permit can be issued. Failure to comply with the above conditions can result in a "Stop Work" order on the project, permit revocation, forfeiture of fees, and a court summons. (1) Any homeowner of an attached dwelling and any unpaid volunteers or paid workers employed by said owner who perform only minor alterations and repairs to such building, provided that all such work is under the continuous personal supervision of said owner, and further provided that NO homeowner of an attached dwelling, or unpaid volunteer or paid worker employed by said owner, may engage in the following types of work without obtaining an appropriately licensed City contractor: (a) Alterations to the primary or secondary structural frame work (except for the repair and replacement of existing window and doors, provided that such repair or replacement does not create larger openings or greater spans for such headers); (b) Alterations to fire -resistive assemblies as defined in the building code, (c) . Alterations to or the installation of electrical, plumbing or mechanical systems, (except for electrical/plumbing fixture replacement in the same location as original). , (d) Replacementlinstallation of more than a total of one (1) square (100 square feet) of roofing.