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Fort Pierce,Florida 3a JqN 18 2018(772)462-1553OWNERBUILDER AFFIDAVIT DISCLOSURE STATri-vcie County, Permitting
F.S.489.103(7)EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you,as the owner of your property,to act as your own contractor even
though you do not have a license. You must provide direct, on-site supervision of the construction yourself. You
may build or improve farm outbuildings, a one-family or two-family residence for your use and occupancy. You
may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own
use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building.
If you sell or lease a building you have built or improved within one year after construction is complete, then a
presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. You
may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is
your responsibility to make sure that people employed by you have licenses required by state law and by county or
municipal licensing ordinances. You may not delegate the responsibility for supervising work to a 'censed
contractor who is not licensed to perform the work being done. Your construction must comply with all pli 1
laws,ordinances,building codes,and zoning regulations. Initial t
I understand that the building official and inspectors are not there to design or give advice on hoLctoe1
the minimum code. Initial / /(
I understand that as an owner-builder that any contract disputes with sub-contractors and I must b�handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initialy�
I understand that if I compensate any person or company for work performed they are requjNd to be
licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and li ef
cost of the license. Initial /&
I understand that if any person that is unlicensed and uninsured gets injured on my constructioi�project
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and rel mg8jcp(1
cost,which could include loss of wages during recovery from their injury. Initial
To qualify for this exemption under this subsection,an owner must personally appear and sign the building
permit application and initial the above.
I hereby acknowledge that I have read and understand the above disclosure statement and that I further
understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and
Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowled d on this
day of of 20
r, y W uj
Owner/Builder Signature
STATE OF FLORIDA
COUNTY OF sk. L J i 4
The foregoing instrument was acknowledged before me this X day of :�q ,20,'l ,
by �,. _o, r��g s v-r\ who is personally known to me,or who has
produced as identification.
e a✓\ytiar CI-ANNA lkIARIE GIwIEP.S
Signature of No Type or Print Name of No N "_ t; MY COMfAISS10J3Gd)l22023
o EXPIRES:December 1G,2020
Title:Notary Public Commission Number Bonded Thru Notary public Underwriters
SLCPDSD Revised 05/15/2014