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Building & Code Regulat'
2300 Virginia Avenue
Fort Pierce, Florida 34982
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATED
F.S. 489.103 (7) EXEMPTIONS II
Sta n o e one by licensei7contractors.,l You have
exemption to that -law. --The exemption -allows your as -the -owner -of -your -property, to ac
though you do not have a license. You must provide direct, on-site supervision of th
may build or improve farm outbuildings, a one -family or two-family residence for y
may also build or improve a commercial building at a cost not exceeding $75,000.00
use or occupancy. You may not build or improve said structures for the purposes of se
If you sell or lease a building you have built or improved within one year after cot
presumption is created that it was built or improved for sale or lease, which is a viol
may not hire an unlicensed person to act as your contractor or to supervise people w
your responsibility to make sure that people employed by you have license's required.'
municipal licensing ordinances. You may not delegate the responsibility for sul
contractor who is not licensed to perform the work being done. Your construction mi
laws, ordinances, building codes, and zoning regulations. it
I understand that the building official and inspectors are not there ito design Ior
the minimum code.
plied for a permit under an
your-own-contractor_even.-- -
onstruction yourself. You
r use and occupancy. You
long as it is for your own
ig or leasing that building.
uction is complete, then a
rn of this exemption. You
ang on your building; it is
state law and by county or
rising work to a licensed
comply with al is e
Initial `
ive advice on ho in t
Initial
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be han d
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial
I understand that if I compensate any person or company for work performed they are required to be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and fable e
cost of the license. f Initia
I understand that if any person that is unlicensed and uninsured gets injured on my constriction project -
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and rela�
cost, which could include loss of wages during recovery from their injury. it Initial
To qualify for this exemption under this subsection, an owner
permit application and initial the above.
I hereby acknowledge that I have read and understand the
understand that any violation of the terms of the owner/builder exe
ZopQ*ng Dep ent to the Florida State Department of Professional
o? lL day of of 29 �.
personally )appear and sign the building
disclosure statement and that I further
shall be reported by the Building and
ion. Signed and acknowledged on this
STATE OF FLORIDA
COUNTY OFZ&,,,t_.a _ aap�
The fo oing instruigent was acknowledged before me this 4R day
by YY who is personally kno
oduced as identificatii
ignature of Notary Type or Print Name ofRotary
Title: Notary Public Commission Number
I�
SLCPDSD Revised 05/15/2014
I'
2C 11 ,
me, or who has
LASHAHNAINGRAM
(fetal}y Public - State of Florida
My Comm. Expires Dec 20, 2018
Commission # FF 177249
Bonded through National Notary As