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0 0 2300 Virginia Avenue
Fort Pierce,Florida 34982 MAR 13 1020
(772)462-1553
ST. Lucie County, Permitting
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMEN
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.
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 an county
or municipal licensing ordinances. Initia
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 ion of
this exemption. Initial
You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to
perform the work being done. Your construction must comply with all applicable laws, ordinances, build' odes,
and zoning regulations. InitiAl
I understand that the building official and inspectors are not there to design or give advice on 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.
Initia
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 lia for the
cost of the license. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my constructi n project-
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relFed.*.cal
cost,which could include loss of wages during recovery from their injury. InitialTo qualify for this exemption under this subsection, an owner must personally appear and sign the builng
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 DepartmlI ggnt to the Florida State Department of Professional gulation. igne a o ed d on this
day of V14i j2A—_Fi of 20 zJ .
Owner/Builder ignature
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this\3 day of #NO{ - --
C 0 t a as " t iy'civS
by �S ua,n��c +� �o S' who is personally kriq�v toovdi i �a�22C23
tY
co missl0i�
produced FL L as'citj �iftion� p cember 15,2020
ublicUnderwriie
Bonded'ThN Notary p
Signature of No ry Type or Print Name of Not `r (Seal)
Title:Notary Public Commission Number C46`�'a4 a.3
SLCPDSD Revised 02/7/20