HomeMy WebLinkAboutWS 15 - Owner_Builder & FIlled Land AffidavitPlanning & Development Services Depi rtnent
Building & Code Regulntiuns
2300 VirBinin Avenue
Port Pierce, Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489,103 (7) EXEMPTIONS
State lav 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 buil( or improved within one year alter 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 RW
I understand that the building official and inspectors are not there to design or give advice on holy to meet
the minimum code. Initial /GO
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 Jrff
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, l maybe responsible and liable for the
cost of the license. Initial 4ffl
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
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 1 have read and understand the above disclosure statement and that I further
understand that any violation of the terms of the ownertbuilder exemption shall be reported by the Building and
Zoning Deparlmnim too the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of /1MILL of 20�.
�� Owner ignatne
STATE OF FLORIDA
COUNTY OF PALM BEACH ,,,�ttt """" ��'� ��'�'''' ��.' �,
The foregoing instrument was acknowledged before me this,:41 day of O 20&,
by KEVIN BOBKENHAGEN who is personally known x to me, o• who has
produced as identification.
TH
KEVIN WIRTH EM
KEVIN state
Public -Stale of FloridaSig ature ofNotary Type or Print Name ofNotary mmissiopn N GG 917671Title: Notary Public Commission Number GG01701 2023
mm. Ex fires Sep 29,ough National Notary Assn.
SLCPDSD 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
1, the undersigned, am the owner of the following described property,
S! wo A-yrn i hs- Pi A I t
for which i have applied to St. Lucie County for a Final Development Permit. LI
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, l 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 me (Please Print)
Property er ftnature Date
STATE OP FLORIDA, COUNTY OF PALM BEACH
ACKNOWLEDGED DEFOREMETHIS._ 23 DAY OF [AAAA, 20
BY KEVIN BORKENHAGEN WHO IS PERSONALLY KNOWN TO WHO HAS
IDENTIFICATION.
KEVIN WIRTH
SIG TURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GG917671 COMMISSION NUMBER ,:ti'pti"ny*. KEVIN WIRTH
Ez° • fir; Notary Public - State of Fiorid:_ -
• , d; (SEQpnrmsslon # GG 917671
` °r 4 My Comm. Expires Sep 29, 2021
Bonded through National Notary Assr.
SLCPDSD Revised 04/11/2011