HomeMy WebLinkAboutSub-Contractor AgreementPERMIT # ISSUE DATE
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For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Sub -contractor for
Street Address or Property
(Primary Contractor)
have agreed to be
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
COn OR SIGNATURE (Qualifier)
PRINTNT NAME
(\I) Pr
COUNTY CERTIFICATION NUMBER
State of Florida, County off Wt-I e, Co
The foregoing instrument was signed before me this day of
3pe!mmflly known_or has produced a 1
as identification.
STAMP
Sigu. tore ota ub Ic
ail
Print Name atNot
a Public
{EN"KP= AUDREYS.HUMPHREY
,. WC06011SSIOH9GOW17
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SUB-C I�fItACT03 SIGNAS URE(Qumn"er)
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COUNTY CERTIFICATION NUMBER
State of Florida, County of UV ,
regoing instrument
��was signed before me this day of
Z
is personally known _or has produced a
as identific. 'an.
'STAMP
Signature of Notary Publi
Print Name of Notary P 1pHe
[go,,,AUDREYB.HLWPHW
MY CGMMISSI0H#G()'4"17
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Planning & Development Services Department
Building & Code Regulations
2300 Virginia Avenue
Fort Pierce, Florida 34952.
(772) 462-1553 :••
OWNER/BUILDER 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
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 is not licensed to perform the work being done. Your construction must comply with a ap licable
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 hpto meet
the minimum code. Initial Z�
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_
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 or 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 be held liable for all doctor, lawyer and relaVgtedical
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. ed and acknowledged on this
day of of 20 ZU
STATE OF FLORIDA
COUNTYOF2iAIACAE
The foregoing instrume\nt was acknowledged before me this
by �h�OOS 1CZ%ll� 1 who is p
produced
Owneroilder Signature
day of 20W,
ly known to , or who has
as
Signatur f Notary Type or lirrint Name of Notary
Title: Notary Public Commission Number 052
SLCPDSD Revised 05/15/2014
_.'r Notary Public State of Florida
Alyssa Mddine
My commission GG 300523
ppw n04114/2023
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 2313-211-0006-000-7
State of Florida County of St. Lucie
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
Legal Description of Property: (and street address if available):
Lot 13, Block 157 of Lakewood Park Unit 2
General description of improvement: Construct new garage
Owner information or Lessee information if the Lessee contracted for the improvement
Name Robert & Jennifer Jacquin
Address 1013 Copenhaver Road Ft Pierce FL 34945
Interest in property: Owner
o i
Name and address of fee simple titleholder (if different from Owner listed above):
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V
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Contractor's Name: Owner
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Contractor Address: Phone Number: 772-528-0801
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ON
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
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Name and address: Phone number:
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V 2L Go
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Lender Name: Phone Number:
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Umm
Lender's address:
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Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Sect :w Z u m o
713.13(1) (a)7., Florida Statutes:
0 a ¢ w
Name: Phone Number:
wt LL o m
Address:
In addition to himself or herself, Owner designates
Uenor's Notice as provided in Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner:
to receive a copy of the
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penal perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my kDowt6gQr6dbelief.
Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager
OG a,Pr
(Signatory's Title/Office)
The foregoing instrument was acknowledged before me this day ofJ�., 20_�
Byr_ lhbti%�UQlAtn as T)A3ol!Ej for_
Name of Person Type of authority (e.g. officer, trustee)
(Signature N Notary Public -State of Florida) �y-"
! Notary Puodito of Florida
(Print, Type, or Stamp Commissioned Name of ota�ub'c)Alyssa Mone
line eN` My Commission GG 300523
�i Expires 04/142023
Party on behalf of whom instrument was executed
nally known /� or produced Identification_.
of Identification produced