HomeMy WebLinkAbout1100 Sycamore St - Affidavits/Homeowner - 06/12/2019City of Building Services
PO &t CoWs 281 N Co80
Il 281 ltese Ave
Fort Collins, CO 80574
970-416-2740 phone 970-224-6134 fax
�,^ J HOMEOWKER AFFIDAVIT
I/we, I r a e �v �` R_ , as owner(s) of record of the property located
At: �b GQ rY�oy� SPe�— Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies):
OPTIOM 4:
❑ 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 primapf residence. I/we have not personally constructed any other new homes
in the Fort Collins city limits within the past 24-month period.
OPTION 2:
1 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 Drimartt
residence.
®PTION 3:
❑ 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 farnily dwelling
unit. The house to be altered is my/our personal primary 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 wort: is directly related
t • the 1 construction of the abo a referenced home, which is described more fully on Permit Application #
_ 9 ined from the Building Services office).
1/ ✓" urideistarld tear aruy Nam.__. , ) 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
IWL MAW �Qhw-
Owner
Co-owner
The foregoing Affidavit was acknowledged before me on this � - day of
J14 Me Z01 (month, year) by 141ijY1 Q 2r&%LP
Witness my hand and official seal
My commission expires �—
CO INANotaHARTPubliOG
State of Colorado
Notary ID k 20174008846
My Commission Expires 02-27-2021
Notary P c
Revised 611012014
Building Services
281 N. College Ave.
P.O. Sox 580
Fort Collins, Co 80524
Voice:970.416.2740 FAX:970.224.6134
City of
Fort CoUins
- -
Revised 7/7/2ol4
Homeowners of a DIEATCHED 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, tlte.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
XI.TERATI®NS AND REPAIRS" by City Code as follows:
"A buildh7g owner tu7d tun, unpaid voltmleers or paid irorkers employed by said ou-ner• u•ho petfornt only minor alterulirnts
and repairs to such building, proviced that all such trork is trader• the continuous personal sul r rision of said owner, anti
fin•lher pravi&tl 117at no bidltlhgg mi-ner, or unpaid rohuueer or paid trorker employed ht• said oirne•r, may engage in the
fal/mring Imes of irork irilhatcl ohlainhnq the appr•oprlale contractor license. "
Furthermore, the wort: must be limited to minor alterations and repairs, which, D® 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. 11. of roofing.
PAID WORKERS
Regardless of ownership status, paid non -owner %vorker(s) or contractors performing overall project supervision MUST BI--, A CITY
LICEINNEli GENER_-ILL CONTILA.CPOR. Any paid specialized trades that perform any one orthe fotlowing: structural wood framing,
roofing, electrical. plumbing. or HVAC, MUST BE SUB -CONTRACTORS licensed by the City.
:UTLICATIONS & PILNAIAJES
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 he issued. Failure to comply Nyith the above conditions
can iesult in a "Stop Work" order on the project, permit revocation, forfeiture of fees, and a court summons.
E\ENIPTIDNS
(1) Any homeowner of an attached dwellinly 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 lamer 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) Replacement/installation of more than a total of one (I ) square (100 square feet) of roofing.