HomeMy WebLinkAbout615 S LOOMIS AVE - AFFIDAVITS - 9/23/201910: VVnvm, r,vmmuc.. n, vuryvur....wyo•an.wu.
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City, of Building Services
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L ,= ,. i' PO Box 580
ort Collins 281 N College Ave l
�-- Y - ForKollins, Co 80524
970-416.2740 phone 970.224-6134 fax,
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HOMEOWNER AFFIDAVIT. '.
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as owners) of record ofthe property located
—�P- ,Fort,Collins, Colorado, hereby declare and attest
to the -following: (please check only the one that applies):
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Q I' aml we are acting on my/ our behalf for the purpose of obtaining a building.permifand -
personally constructing-my/our home. The home lobe constructed is on the above property -and;
will be my/our rima 'residenee.'lAve have not personally constructed any -other new homes ---
in the Fort Collins citylimits within -the past 24-month perm: -
f r'UPT-• r a.1 .t • '` . v1. i = > }_.• ,� �'• {.. ,, of _ ', r, -. 'i. • „ Y
B' I am/we are acting,on my/our,betial€.forthe purpose of obtaining a building permit and
personally conshucting an alteration or addition to mylotir house, acing as our own general ;
contractor. The'house to be altered is -,on the above property and is mylounorsonal PrIma6v
residence. : -
-
❑ I,am/we are acting on mylourbehalfforthe,purpose of,otitaining,a building permit and
persondOy constructing a noii-strudfiral alteration to-my/out attached single family dwelling .
unit The house.to-be altered is mylourpersonal griinary residence.'I am aware that Uwe
cannot do any.structural,:electical, plumbing or mechanical work and must Eire
contractorsisubcontractors who aye; currently" licensed and insured with the City -of FortCollins:
l am/We are personally pedbrmirig,all of the work,* Who City of Fort'Collins licensed trades people, or v+n7I b-
continuously supervising unpaid yolunteers, (see 'Option;3 for attached. dwellings). The.work is directly related .
to the construction oftheraboVe referenced'h6me„which is described more fully on Permit Application
(obtained from the Bu�cftservices office):
• I/we understand that anyperson(s) or agents) contracted -to perform structural.wood-framing, plumbing, -
HVAC, electrical or roofing work,'MU$T bUicensed contractors in' accordance with the, regulation of the City,
i' 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 numbs r, forfeiture of any fees_that have been collected, a Slop
Work Order''end, potentially a'court summons.
i Sign in ue presertcs,o/NoteryPubUc '
Ii
i Owner I Va co owwr
j The foregoing Affidavit was acknowledged before me on this �3rc day
.,'(month year) by .(� % f '� $r) f7 L� _ j.+'1 _ e r�► r r .� ; , ` )
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I
r' Aycommisslonexplres: 60�3 Zv"Z?: ;� Notary Public ;f
Revised 61i01201
Budding Services _ �city, of
281 Box
Are
P.O. l COl[itiS d
� P.O. Baz 530
Fort Collins, CO 80524 t
Vol= 970.416.2740 FAX- 970.224.6133
Revised 7i7i2014
• HOMEOWNER AFFIDAVIT - ,: , _ Re , ,
Homeowners of a DETACHED single-family home may personally perform and for tact as their own general contractor for any work'
on their PRIMARY residence. Permit requirements are applicable. if said homeowner hires and pays anyone for nark that requires a
City licensed eontrartor, the City licensed contractor creeds to be listed on the building pcnnut application, and will need to be current
~ on City littnse and insurance requirements before the building permit can be issued.
Homeowners of an ATTACHED single-family home (tO>snhause, condominium or duplex), may perform LIMITED "MINOR
' ALTERATIONS AND REPAIRS" by City Code as follows:
j "A building Owner and any unpafd rolumeers or paid workers empla}rd by Bald owner selro perform only minor alterations
' and repairs to surly bufldfng prorlded char all such work is under the eanrimrous prnanol supervWon of said owner, and
further provided tlwt no building owner, or wrpaid rolumeer or paid worker employed by said Owner, may engage in the
i following ppcs of work without obtaudng the appropriate !Fonuperor Jiceme. "
Furthermore, the work must be limited to minor alterations and repairs, w'hieb, DO NOT Whine:
1. Any alterationsrrnstallations iavolvias 6m4esistive,usembl es, alterations to primary and secondary fiamework, electrical,.
plumbing. or mechanical systems and replacernmt of more than 100 sq. ft. of roofing_
' PAIDSVORKERS _ .
Regardless of ownership status, tU nan-otmer warker(s) Or contractors perfami ottrdl pmJeri supervision MUST BEmni
LIM%SED GE3%ERAL CO�'rRACCOR. Any,paid specialized trades that perform way one of the following_ structaual.wood framing,
roofing electrical, plumbing, or HVAG MUST BE SUB -CONTRACTORS licensed by the City.
ONS& PF� N�tI77FC '
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A homeowner acting as their own "general CarmtlfetOr for tiWk_ oti,iheir own ptimaty residence, mast submit a notarized City
Homeowner Affidavit form to BuMing Services before a building pem»t can be issued Failtae to comply with the above conditions
i can result in a "Stop Wororder on the project' permit revocation, forfeiture Of fees, and a court Snminamts.
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E,XEMPTiONlS
(1) Any homeowner of an attached dweiling and any unpaid volunteers or paid workers employed by said owner who perform
ottly minor alterations and repairs to such building, provided,that all such work is imder,the continuous personal supervision of ,
said owner, and further provided that NO bomMw'ner of an attached dwellinlz, or unpaid volunteer or gRid
worker emploved by said owner may eotaee is the foilowine types of work without obtain sin
r appropriately licensed Cih contractor:
(i} Alterations to the primary or secondary stnrctmil frame work (except far the repair and replacement of axis ting
window and doors, provided that such'repair or replacement does not create Larger open . ings or greater spans for
' . .
I (bJ Alterations to fife -resistive assemblies as defined lathe building code, y
(c). Abeniiaus to or the installatioO of electrical, phmmbing or mechanical systems, (except far, electrici ftlumbing • '
fimaure n�miaament in the slime location as oribieal)• " ;
t1 (d y R Iatstaltation of mom than a total of ow (1) square (100 square fat) of rooting. -
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