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HomeMy WebLinkAbout428 REMINGTON ST - AFFIDAVITS - 2/27/20090 mmeri k� s_ervices 3uilding and Zoning Department BUILDING OWNER /AGENT AFFIDAVIT R090107 xl/welf . (7),:J m. o' -�'OV , as owner(s) of record of the property located SIC at Fort Collins, Colorado, hereby declare and attest to the following: (please check the box that applies) 0 I am/we are acting on my/our behalf for the purpose of obtaining a building permit for minor alterations to the building referenced above. 1 am/we are personally performing all of the work as allowed by City of Fort Collins code and as approved on permit # . I understand that all work related to electrical, plumbing, HVAC, gas piping and fire extinguishing systems must be performed by a City of Fort Collins licensed subcontractor and that this work cannot commence until the City of Fort Collins Building & Zoning department is notified of the subcontractor. I/we am/are personally acting as the General Contractor for the purpose of obtaining building permit. / # for minor alterations to the building referenced above. I know that the labor, material and profit of the permit cannot exceed $5,000. 1 understand that all work related to electrical, plumbing, HVAC, gas piping and fire extinguishing systems must be performed -by a City of Fort Collins licensed subcontractor and that this work cannot commence until the City of Fort Collins Building & Zoning department is notified of the subcontractor. 0 Uwe do authorize -. (Agent) to act on my/our behalf for the purpose of obtaining a building permit for minor alterations (no structural alterations) to the building referenced above. Said agent will be personally performing all of the work as approved on permit # I understand that all work related to electrical, plumbing, HVAC, gas piping and fire extinguishing systems must performed by a City of Fort Collins licensed subcontractor and that this work cannot.commence until the City of Fort Collins Building & Zoning department is notified of the subcontractor. Uwe understand that the Agent named above is not a contractor and is my/our employee as defined by Colorado law; or is acting on my/our behalf without any fee, compensation, or trade in -kind for the above work. Further, I/we understand that payment of such fees or compensation for the above work, to any person who is not in my/our employ as described by Colorado law, constitutes a "construction contract" and violates the Contractor License provisions of the Fort Collins Code and will result in revocation of the above permit, forfeiture of fees and a court summons. Sign in the presence of a Notary Public Owner Owner 1",4 f®r, ) A, A 4� Agent this day of (m ogn t ­h, year) The by_ �A L� was ckno lec 1pli�efore Witness my hand and official seal My commission expires N� �o0809 ON GF C O r� e �"'oell NIIlOO ok EXPIRES O. Paoy 1 �1. Notary Pub'