HomeMy WebLinkAbout1327 VINSON ST - AFFIDAVITS - 4/18/2007FROM :NCA
AUG-07-2006-MON 12A2 PM
FAX NO. :9702299983 Apr. 18 2007 08:21AM P2
P. OU I %O0
Community Planning and Environmernfal Services
Building and Zoning Department
HOMEOWNER/BUILDER AFTIi "IT
of of Fo..�:��. L C`7
as owner(s) of record of the property located
I/we, _
( lease print) Fort Collins, Colorado, hereby declare and attest to
at: 132'7 1� n`��1"
(please print) .
the following: (please check A, a or C, whichever applies)
❑ A. I 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. Vwe have not personally constructed any other new home in Fort
Collins city limits within the past 24-month period.
a B. 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 home. The home to be altered is on the.
above property and is my/our personal residence,
❑ C. I 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 home to be altered is our personal 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 with the City bf 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 AppllCation # (obtained from.oullding and Zoning
office). •I/we.Understand that any persons or agents contracted to perform structural wood -framing,
plumbing, HVAC, electrical work, roofing of cast-iri-place structural concrete. work, MUST BE.licensed
contractors In accordance with the regulation of the City of Fort C011in5:
i/we understand that failure to comply with any of the above condltions may result in revocation of
any permits associated witty the above Permit Application number, forfeiture of any fees that have been
coliected, a Stop Work order and a court summons.
Sign in the presenca fa,9Votary Public
owner owner
The foregoing Affldavit was acknowledged before me on this Y ay of
n .. r , t nrY"s I (,n, q0)u, Year)bY C.ilY i 6
witness my hand and
My commission expires:
ditch °312010
y 4; HARp�!
�pTARY ��•:
PUB00
OF Cps:
Public
281 Noah College Avenue
Collin; Co 80522-0580 • (970) 221.6760 • FAX (970) 224-6134