HomeMy WebLinkAboutOwner Builder Affidavit i
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STALK E Planning&Development Services Department
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Fort Pierce,Florida 34982
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OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT
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 1
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 licensed
contractor who isnot licensed to perform the work being done. Your construction must comply with all a1p icable
laws,ordinances,building codes,and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on how to meet
the minimum code. Initial___.(/
I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial 41
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 li le for the
cost of the license. Initial"
I understand that if any person that is unlicensed and uninsured gets injured on my construction project-
they may be entitled to workmen's compensation. I could beheld liable for all doctor,lawyer and related medical
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 Florida Stat�epartment of Professional Regulation. Signed and acknowledged on this
�_ ay of of 20
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Owner/Builder Si ture
STATE OF FLO A
COUNTY OF ,'�'• CA�-
The foregoing instrument was acknowledged before me this day of ri I ,20 `O
b, Lei( 14 3. gaV r..-.s who is personally known to me,or who has
r •i uc-d (. as identification.
irnature of Notary Type or Print Name of Notary (Seal)
itle:Notary Public Commission Number _,,„_,-\--,
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,,,,,n,,e,, LASr'ANNA INGRAM
SLCPDSD Revised 05/15/2014 ; 2A :#\; 'I` 'L - State of Florida
�� I ,) i, , 1" L _'C 20,2C1i8
. Fort Pierce Liti 1 ities,
_ • 200 S bth Street •
Fort Pierce, FL 34950
• Telephone No. (772) 466-1600,
04/24/18 1 :11PM
Receipt #: 003180424000040
Customer #: 168970
Location #: 10007553
For: -. LELIA J BARNES
Payment Received: ' 290.00
Amount Tendered Check: 290.00
Check Number : 847,
Payment will be posted: 04-24-2018 •
• • ! Register: CASHIER3i.
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CUSTOMER COPY
Pry . Fort Pierce Utilities Authority
' *�.` 206 S 6th Street
_tor: 'Fort Pierce, FL 34950
• Receipt Number: PYMT00005790167
• Receipt Date: 4/24/2018
Customer ID: 168970
Location ID: 10007553
On Behalf of: Re Service Address:
LELIA J BARNES'
PO BOX 1011 1808 50 ST
FORT PIERCE FL 34954-1011 FORT PIERCE FL 34947 .
USA USA
Total Amount Received by Check $290. 00