HomeMy WebLinkAbout2943 Eastborough Dr - Affidavits/Homeowner - 02/07/2019 (3)b I Scx►O'S Z
}� rvIces
PO 18ox 580 >'0000
`Collins 281 M College Ave o J( f
Fort Collins. Co 9000
970-416.2740 phone one 970.2246134 fax
HOMEOWNER, AFFIDAVIT
{I`� as owners) of record of the property located
At n2 � � �Sf',1� M4k ,�r. Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies):
OPTION is P/I
PI 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 prJmutim residence. I/we have not personally constructed any other now homes
In the Fort Collins city limits within the pest 244nonth period.
.OPTION 21
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 a imerr
residence.
OPTION Se
13 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 rapt residence. I am aware that Uwe
cannot do any structural, electrical, plumbing or mechanical work and must hire
contractora/subcontrectors 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 Penult Application #
(obtained from the Building Services office).
Ilwe 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 /n the press of Note PubJ7c
C
v
Owner Coowner
That egoing Affidavit was acknowledged before me on this day of
I S (month, year) by!'L1� JG�
Witness my hand and official seal
My commission expires:
Revised 6h0RO14
O?S3�