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HomeMy WebLinkAbout4501 SEAWAY CIR - AFFIDAVITS - 10/20/2008Community Plarning and Environmental Services Building Services HOMEOWNER/BUILDER AFFIDAVIT City of Fort Collins s ��G� I/we, _I , as owner(s) of record of the property located �I (please print) CSC. C/ at 4-,r-'- , Fort Collins, Colorado, hereby declare and attest to (please pnktjj 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 my 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 of Fort Collins I am/we are personally performing all of the work, or will be continuously supervising unpaid voluntee,s Tne 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 ner Owner The foregoing Affidavit was acknowledged before rnp on this ae day of (j�2jSh6'." oqjj�) (month, year)by Witness my hard and My commission expires 'r BEN THARP r Notary Public W COMMISSION EXPIRES A.423.20111 281 Nort i Colleje P �enL e PO Eo- 580 Foi, Coll 1 CO 86522 0D80 (970) 221 6760 FAX (9-0) 22a 51.)'