HomeMy WebLinkAboutNelsen City of Fridley Building Applicant prop own form CiT"Y flF
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BUILDING PERMIT AI'PLICAl�1"I': PROPERTY O WNER
b[5�� —, understand that the State of tvInulesota req
uires
zit all residential building contractors, remodelers and roofers obtain a state license
tulles they qualify for a specific exemption from the licensing requirements. This license
requirement applies to owners of residential real estate who build or improve such
property for purposes of speculation or resale.
BY signing this document, I attest to the fact that I am improving this house for my own
use and am not building or improving this house for the purpose of resealing it. I hereby
claim to be exempt fi'om the state licensing requirements because I am not in the business
of building or remodeling on speculation or for resale and that the house for which I am,
applying for this permit, located at .
is the only residential structure I have built or improved the ast 4 mo I also
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a.ckaowledge that because I do not have a state license, I forfeits any mechanic's lien
rights to which I may otherwise have been entitled under Minn. Stat. §514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is it
misdemeanor under Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to
S 10,000. 1 furdher state that I understand that the filing of a false statement with
q'he City of Fridiev may also result in criminal prosecution and/or civil penalties
to applicable city ordinances and/or state statutes.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to The City of Fridley for compliance will
all applicable building codes and city ordinances with the work being preformed on this
property.
Sign turre.00ff Property Owner
Date
For questions or information on contractor licensing, or to check the licensing status and cnforcem nt
history of a particular contractor, call the Minnesota Department of Labor and (ndustry,Construction
Codes and Licensing Division, at(651) 284-5069.The web site is: het J/www.dli,rnn. ovi '�Ii.as�