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HomeMy WebLinkAbout618 HOLYOKE CT - AFFIDAVITS - 3/26/2003CommurLity Plarinirig arid EnNdr€artmerital Services Buildirto acid Zomrio Department HOMEOWNER/BUILDER A,FFI©AVIT CYt>> of Fort Collins � 80301 I/we, �V�Z (ple, print) 337 as owner(s) of record of the property located at. / v yDne CH_ �CO., Fort Collins, Colorado, hereby declare and attest to (please print) the following: (please check A, B 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. 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'/we 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 construction of the above referenced home, which is described more fully on Permit Application # (obtained from Building and Zoning Office). I/we understand that any persons or agents contracted 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 presence of a Notary Public 4&O7we"r" Owner Th foregoing Affidavit was acknowledged before me o this day of -� _(month, year)by Witness my hand and official sPal My commission expires: MY Commission Expires 11/10/2006 otary Public 2£1 North College Avenue ^ PO. Eo>: 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134