2. This form is required for all permits and certifies that the contractor will build pursuant to code.
4. Instructions

   BE SURE TO SELECT "SUBMIT AND PRINT" UPON COMPLETION OF THIS FORM. ONCE YOU HAVE GENERATED THE PDF, LOAD IT INTO YOUR CONTRACTOR REGISTION ON COMMUNITY CORE

6. Contractor Information
8. First Name*
9. Last Name*
11. Email Address*
12. Telephone*
14. Site Address*
16. City*
17. State*
18. Zip*
20. This is to certify that I am responsible for (check all that apply):*

    1. Commercial
    2. Residential
    3. HVAC
    4. Electrical
    5. Low Voltage
    6. Mechanical
    7. Plumbing
22. Sign Off *

    1. I, the contractor, hereby certify

    that I have and will comply with all codes and ordinances adopted by the City of Avondale Estates that pertain to the construction of this site. In the event of any change on the status of this installation, I understand that I will be held responsible for all indicated work at this job until Business Inspections has been notified in writing. I further agree to indemnify The City of Avondale Estates and its operator from any liability for damages and loss of property if the work performed under my authority has not been installed in accordance with these codes and ordinances.    

24. Contractor Full Name: *
26. Business License #*
28. State Trade License #*
30. Business Name: *
32. Business Phone: *
34. Date:*
36. How to obtain a PDF copy of the affidavit:

    1. Ensure "Receive an email copy of this form" is selected and enter your email address.

    

    2. Click "Submit and Print" to receive a copy via email. Another window will open to print the affidavit or save it as a PDF.

Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field