HomeMy WebLinkAbout4980 HOGAN DR - AFFIDAVITS - 2/9/2015Cu of I building Services
RC}GPO Box ii ` o ' C1 C Gns 281 N Collllege Ave
% Ft Collins, CO 80524
970-416-2740 phone 970-224-6134 fax
HOMEOWNER AFFMIMT
I/we,
as owner(s) of record of the property located
At:
Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies)
OPTION 1:
�m/ we are acting on my/ our behalf for the purpose of obtaining a building permit and
rsonally constructing my/our home. The home to be constructed is on the above property ar
will be my/our prima residence. I/we have not personally constructed any other new homes
in the Fort Collins city limits within the past 24-month period.
OPTION 2:
❑ 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 house, acting as our own general
contractor. The house to be altered is on the above property and is my/our personal prima
re
residence.
OPTION 3:
❑ 1 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 house to be altered is my/our personal primary 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 and insured with the City of Fort Collins.
I am/we are personally performing all of the work or hiring City of Fort Collins licensed trades people, or will be
continuously supervising unpaid volunteers (see Option 3 for attached dwellings). The work is directly related
to the construction of the above referenced home, which is described more fully on Permit Application #
(obtained from the Building Services office).
Uwe understand that any person(s) or agent(s) contracted to perform structural wood -framing, plumbing,
HVAC, electrical or roofing work MUST BE licensed contractors in accordance with the regulation of the City o
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 potentially a court summons.
Sign in the presence of Notary Public
Owner
Co-owner
The foregoing Affidavit was acknowledged before me on this _ / day of
UI (month, year) by
Witness my hand and official seal
My
RGARET R. CLANCY
NOTARY PUBLIC
ATE OF COLORADO
ID # 20134040425
FENOTARY
SION EXPIRES AUGUST 06, 2017
ublic