Southgate, MI · Wayne County
Homeowner's Affidavit
Homeowners complete this affidavit to request a permit for work on a single-family residence and accept responsibility for the work and required inspections.
What this form is
Homeowners use this affidavit to request a homeowner’s permit for work at a single-family residence. It asks for the owner’s name, address, phone number, email, and a description of the work. By signing, the owner accepts responsibility for the work and inspections, agrees to notify the department within 24 hours for inspections, and agrees to correct violations within two weeks.
Who needs it
A homeowner of a single-family residence who wants to request a permit to install work described on the form should complete it.
How to submit it
The form names the Department of Building and Safety Engineering at 14400 Dix-Toledo Road, Southgate, Michigan 48195. It lists no submission email or portal.
About notarization
This affidavit has no notary block; the homeowner signs and dates it, and the form also provides a witness signature line.
How to submit this form
- 1
Download The Affidavit
Download the Homeowner's Affidavit PDF.
- 2
Complete The Form
Provide your name, address, phone number, email, and a description of the work.
- 3
Review And Sign
Review the stated responsibilities, then sign and date the affidavit; the form also has a witness signature line.
- 4
Submit To The Department
The form lists the Department of Building and Safety Engineering at 14400 Dix-Toledo Road, Southgate, Michigan 48195.
Frequently asked questions
- What does the Homeowner's Affidavit request?
- It requests a homeowner’s permit for work at a single-family residence and records the owner’s contact information and a description of the proposed work.
- Do I need a notary for the Homeowner's Affidavit?
- No. The affidavit has no notary block; the homeowner signs and dates it, and the form also provides a witness signature line.
- How do I submit the Homeowner's Affidavit?
- The form lists the Department of Building and Safety Engineering at 14400 Dix-Toledo Road, Southgate, Michigan 48195. It does not list an email or online submission option.
- What responsibilities do I accept by signing?
- The signer accepts responsibility for the work and inspections, agrees to notify the department within 24 hours for inspections, and agrees to correct violations within two weeks.