HomeMy WebLinkAbout938 W MOUNTAIN AVE - AFFIDAVITS - 3/23/2006Citv of Fort Collins
I/we,
at:
Community Planning and Environmental Services
Building and Zoning Department
HOMEOWNER/BUILDER AFFIDAVIT
W , as owner(s) of record of the property located
Yl hL4!_ , Fort Collins, Colorado, hereby declare and attest to
(please print)
the following: (please check A, BorC, 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. I/we have not personally constructed any other new home in Fort
Collins city limits within the past 24-month period.
❑ B. 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 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. I,hAfe must hire contractors/subcontractors who
are currently licensed with the City of 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 constru tion of e bove r ferenced home, 'which is described more
fully on Permit Application # _ (obtained from Building and Zoning
Office). I/we understand that an e on o gen s tnWOM to perform structural wood -framing,
plumbing, HVAC, electrical work, roofing or cast=in-place structural concrete 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 a court summons.
Sign in the pr ce of a o ary Public
Owner
Owner
The foregoing Affidavit 1�'�M�pp�'4ged before me on this a 3 day of
year)by uL A-
Witness my hand aril f€icial sea��
®LIC
My commission ex ® �O
�0R��o
Notary PLfllio
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 - (970) 221-6760 • FAX (970) 224-6134