HomeMy WebLinkAboutWS 54 - Owner_Builder & Filled Land AffidavitPlanning & Development Services Department
• Building & Code Regulations
e e 2300 Virginia Avenue
--- Fort Pierce, Florlda 34982
(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 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 a
I understand that the building official and inspectors are not there to design or give advice on hov{Lo meet
the minimum code. Initial i0
I understand that as an owner -builder that any contract disputes with sub-conlractos and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial Aw
I understand that if I compensate any person or company for work performed they ore 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 49
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 '<ff
To qualify for this exemption under this subsection, an owner must personally appear and sign the building
permit application and initial the above.
T 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 ownerlbuilder exemption shall be reported by the Building and
Zoning Department to the Florida State Deportment of Professional Regulation. Signed d Acknowledged on this
_$_ day off'Ijl �of20a&.
Owner uildm atore
STATE OF FLORIDA
COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this _$__ day of20_W
by KEVIN aOaKENHAGEN who is personally known x to me, or who has
produced as identification.
Sf6aturc of"Notary
Title: Notary Public
SLCPDSD Revised 05/15/2014
KEVIN WIRTHpy'a$,,,
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d
-��ar -
KEVIN WIRTH
aq' Public - State of Florida
Commission l]s
Type or Print Name of Notary
Commission Number OG917RI
S p 29. 2
My Comm. Expires Sep 29. 2023
Bonded through National Notary Assr.
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT' PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner ofthe following described property,
Id#/Legal
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 so 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 BORKENHAGEN
Property Owner Na (Please Print)
Propertyer Signature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS DAY OF 1il�A/� .2050
BY KEVIN BORKENHAGEN WHO IS PERSONALLY KNOWN TO ME M OR WHO HAS
PRODUCED
SIO URE OP NOTARY PUBLIC
GG917671 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
KEVIN WIRTH
TYPE OR PRINT NOTARY
SO$ KEVIN WIRTN(A &W publicSlate of Floridat Commission # GG 917671 My Comm, Expires Sep 29, 2023
®®aded through National Notary Assn.