Legal Permit Affidavit

LEGAL PERMIT AFFIDAVIT

Affiant Name: , Title: , Affiant Entity Type: Owner Contractor

Permit Applicant Name: , Permit Number:

Property Address:

RECITALS

WHEREAS, the Permit Applicant has applied for a permit described as: , for the property located at the address above; and

WHEREAS, the Affiant is authorized to submit this affidavit on behalf of the Permit Applicant and has personal knowledge of the facts set forth herein; and

WHEREAS, the Permit Applicant requires this sworn statement to attest to compliance with applicable codes, ownership, and control of the subject property and proposed work.

NOW THEREFORE, in consideration of the foregoing recitals and other good and valuable consideration, the Affiant hereby affirms and certifies as follows:

1. STATEMENT OF FACTS

1.1 The Affiant declares under penalty of perjury that the following statements are true and correct to the best of Affiant's knowledge and belief:

(a) Scope of Work:

(b) Estimated Commencement Date: , Estimated Completion Date:

(c) Legal Description or Parcel ID:

2. REPRESENTATIONS AND WARRANTIES

2.1 The Affiant represents that Affiant is the owner of record or an agent with full authority to make this affidavit on behalf of the owner or permit applicant, and that all statements herein are true and accurate.

2.2 The Affiant warrants that all work performed under the referenced permit will comply with all applicable building, zoning, environmental, fire, safety, and other statutory and regulatory requirements in force as of the date hereof.

3. DISCLOSURES

3.1 The Affiant discloses the following related persons, contractors, lien claimants, and interested parties associated with the proposed work:

3.2 The Affiant affirms that there are no pending liens, judgments, or stop-work orders affecting the property or proposed work except as follows:

4. COMPLIANCE, INSPECTION AND ACCESS

4.1 The Affiant agrees to permit authorized inspectors and officials access to the property during reasonable hours for the purpose of verifying compliance with the permit and this affidavit.

4.2 The Affiant shall obtain and maintain all required permits, licenses, certificates of insurance and bonds necessary to perform the work and will provide copies upon request to the permitting authority.

5. INDEMNIFICATION

5.1 The Affiant shall indemnify, defend and hold harmless the permitting authority, its officers, employees and agents from and against any claims, damages, liabilities, costs and expenses (including reasonable attorney fees) arising out of or resulting from the work performed under the permit, except to the extent caused by the sole negligence or willful misconduct of the permitting authority.

6. NOTICES

Any notice required or permitted under this affidavit shall be in writing and delivered to the addresses set forth below by hand delivery, certified mail, or national courier service. Notices shall be effective upon receipt.

7. AMENDMENT AND WAIVER

7.1 No amendment or waiver of any provision of this affidavit shall be effective unless in writing and signed by both the Affiant and the Permit Applicant. The waiver of any breach shall not constitute a waiver of any subsequent breach.

8. GOVERNING LAW

8.1 This affidavit shall be governed by and construed in accordance with the laws of the state in which the property is located, without regard to conflict of law principles.

9. ENTIRE AGREEMENT; SEVERABILITY

9.1 This affidavit contains the entire agreement of the parties with respect to the subject matter hereof. If any provision of this affidavit is held invalid or unenforceable, such provision shall be severed and the remaining provisions shall continue in full force and effect.

10. DECLARATION UNDER PENALTY OF PERJURY

The Affiant declares under penalty of perjury under the laws of the state in which this affidavit is executed that the foregoing is true and correct.

Executed on: at .

Sign Now