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HOMEOWNER PERMIT APPLICANTS, PLEASE READ AND SIGN THE FOLLOWING: Building permits may be issued to homeowner-occupants wishing to act as their own general contractor on new construction, remodeling or repair on their own privately owned residence. City and County of Broomfield ordinances allow homeowners to act as their own general contractor, provided they are doing the work. If the homeowner decides to have another person perform the general contracting work, that contractor needs to come into the City and County of Broomfield Building Division office and sign up as the general contractor of record. The contractor shall be currently licensed by the City and County of Broomfield. Permits may be issued to homeowner-occupants wishing to perform electrical and/or plumbing work on new construction, remodeling or repair on their own privately owned residence. Statutory provisions require that this property is NOT intended for sale or resale; is not rental property which is occupied or is to be occupied by tenants for lodging, either transient or permanent; and is not generally open to the public. I certify that the property is not in conflict with the preceding description; that all electrical and/or plumbing work will be personally performed by me; and that I will request all necessary inspections required by the City & County of Broomfield. All wiring and plumbing shall be inspected prior to covering or concealing by insulation, drywall, paneling, etc., and again upon completion of the system, prior to occupancy and permanent power release. This requires at least two and often three or more site inspections by the building inspector. In the event that corrections are required, a reinspection will be necessary and an additional fee may be charged. Homeowner permits are not intended to circumvent the licensing and registration laws of the State Electrical Board or the State Plumbing Board of non-licensed individuals, firms, etc. All work performed by the applicant and subcontractors shall be done in accordance with the current edition of the International Residential Code and National Electrical Code as adopted by the City & County of Broomfield. Address of Construction Date Print Homeowner Name Signature of Homeowner SIGN