HomeMy WebLinkAboutFilled Land Affidavit J J
O .� Planning&Development Services Department
L� :- .o •=r- o - - ,l Building&Code Regulations
2300 Virginia Avenue
Fort Pierce,Florida 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-
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.
Initial Here.
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.
Initial Here.
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 Here. 2�.IL
I understand that the building official and inspectors are not there to design or give advice on how to meet the
minimum code. Initial Here. 1,/L
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 Here.
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 liable for the cost of the
license. Initial Here. Z-/L
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 Here. ?_/C,
To qualify for this exemption under this subsection, an owner must personally appear, 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 Zonin l
Department to the Florida State Department of Professional Regulation. Si cknowledged on this
day of a MW&4-20_�Z•1
O er/Builder Signature
STATE OF FLORIDA S4.COUNTY OFy
The for ng instrument was acknowledged before me this / day of 20 '�
by Yl who is personally known to me,or who has
produce as identification.
6&'tJ1,66if wL
Signature of Notary a or int Name of Notary (Seal)
g rl' YP
Title:Notary Public Commission Number
AJDREY B.HU�,IPHREY
iv1Y COMMISSIOu t GG 3G0817
EXPIRES:March 6,20%3
Bonded Tlttu Notary Public Unde:v;rit,=.
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY
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,
(Parcel Id#/Legal description/Address)
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 WELL 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.
Property Own ame(Please Pr' t)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 120
BY�A M&� �XU� WHO IS PERSONALLY KNOWN TO ME a OR WHO HAS
P ODUCED AS IDENTIFICATION-
IG TURF 0 NOTARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
�MING
SLCPDSD Revised 04/1 1/201 l SNNp1NGRP '27506fl