HomeMy WebLinkAboutWS 52 - Owner_Builder & Filled Land Affidavit- Lu r r -
Planning & Development Services Department
L4101,41 Building & Code Regulations
2300 Vhginia Avenue
Port Pierce, Cloridu34982
(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 fain 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 o' occupancy. You may not build or improve said siructmes for the purposes of selling or leasing that building.
If you sell or lease a building you have built o- improved within one year after construction is complete, then a
presumption is seated 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 sue that people employed by you have licenses required by slate 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 all applicable
laws, ordinances, building codes, and zoning regulations. Initial K?ffi
I understand that the building official and inspectors are not thereto design or give advice on hov{ to meet
the minimum code. Initial t"ZO
I understand that as an owner -builder (hat any contract disputes with sub-cmdractms and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial 10;
I understand that if I compensate any person or company for work performed they me required to be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the
cost of the license. Initial 1 0
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 related medical
cost, which could include loss of wages during recovery from their injury. Initial 1:'2i;
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 Slate Deportment of Professional Regulation. Signed a acknowledged on this
IF
day of _A_ of 20 Qh.
Owner wilder Sign rC
STATE OF FLORIDA
COUN'T'Y OF PALM REACH
The foregoing instrument was acknowledged before me this __S__ day of 200 ,
by KEVIN BOMENNAOEN who is personally known x to me, or who has
produced as identification.
KEVIN WIRTH KEVIN WIRTH
SVbature of Notary Type or Print Name of Notary 1yotary Public - State of Florida
ccsvB7l er Commission p GG 917671
Title: Nota y Public Commission Number �pr,M1°" My Comm, Expires Sep 19, 1073
Bonded through National Notary Ass,
SLi:PDSD Revised 05/15/2014
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage se that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
KEVIN BORKE 4AGEN
Property Owner ame (Please Print)
Proper O ignature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
ACKNOWLEDGEDBEFOREMETNIS U DAY OF ��20�.
BY KEVIN BORKENHAGEN WHO IS PERSONALLY KNOWN TO ME( v DORWIIO HAS
PRODUCED
SIGN6XURE OF NOTARY PUBLIC
GG917671 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
KEVIN WIRTH
TYPEOR PRINTNOTARY
-'0-, ..., (SWN WIRTH
?° •`+ Notary Public - State of Florida
'151
MY
Commission # GG 917671
'">.':,ns My Comm. Expires Sep 29, 2023
Banded through National Notary Assr.