UNLICENSED BUILDING PERMIT APPLICANT QUESTIONAIRE

YES NO

1. Do you own the land on which this building will be constructed?

If yes, go to question 2.

If no, applicant is not eligible for a permit under "owner's exception".

2. Have you hired or intend to hire an individual to superintend and manage

construction of the project?

If yes, applicant is not eligible for a permit under "owner's exception".

If no, go to question 3.

3. Do you intend to directly control and supervise construction activities?

If yes, go to question 4.

If no, applicant is not eligible for a permit under "owner's exception".

4. Do you intend to schedule, contract, or directly pay for all phases of

construction work to be done?

If yes, go to question 5.

If no, applicant is not eligible for a permit under "owner's exception".

5. Do you intend to personally occupy the building for at least 12 consecutive months

following completion of construction and do you understand that if you do not do

so, it creates the presumption under law that you fraudulently secured the permit?

If yes, applicant may be entitled to permit under the "owners exception".

If no, applicant is not eligible for a permit under "owner's exception".

Printed Name: ______________________________________________________________________

Job Location: _______________________________________________________________________

Signature: _______________________________________ Date: ___________________________