Knowledgebase-Affidavit of Code Official

Information Product

Title:Affidavit of Code Official
Summary:MTAS was asked to create a form for an affidavit of a code official.
Original Author:Darden, Ron
Product Create Date:08/14/2003
Last Reviewed on::12/20/2016
Subject:Code enforcement--Personnel; Code enforcement--Building inspection--Personnel; Code enforcement--Building inspection--Laws and regulations; Forms
Original Document: Affidavit of Code Official.pdf

Reference Documents:

Text of Document: Affidavit of Code Official.doc


State of Tennessee
County of Loudon

1. My name is __________________________ , I am over the age of eighteen (18) and the matters stated in this affidavit are based on my personal knowledge.

2. I am employed in the position of __________________________ by the City of Loudon. In that capacity I act as a Code Official for the City and enforce municipal codes and standards.

3. I received a complaint, or made personal observations, of potential code violations existing on property located at ___________________________________________ in the City of Loudon. The registered owner(s) of this property is/are ____________________________________.

4. The complaint which I received, or my personal observation from the perimeter of the property, leads me to suspect the following violations of the City of Loudon Code of Ordinances: ______________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________.

5. Pursuant to my duties as a Code Official, I contacted the property owner(s) on _________ to arrange for my entry onto the property for the purposes of conducting an inspection.

6. The property owner(s) have refused to cooperate and will not allow me or another Code Official access to the property for inspection purposes.

7. I request that a warrant, or other order issue which would enable me or another Code Official to enter the property for the purpose of conducting an inspection.


The Affiant __________________, who is personally known to me, executed the forgoing Affidavit in my presence, under oath on this _____ day of _____________, 2002.

Notary Public
My commission expires: __________.