HomeMy WebLinkAboutOWNER-BUILDER AFFIDAVIT Sir.[LUCEP.
O Planning&Development Services Department
• • 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.
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If you sell or lease a building you have built or improved within one year after construction is complete, en a
presumption is created that it was built or improved.for sale or lease,which is a violation of this exemption.
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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.
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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.
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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.
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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.
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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.
To qualify for this exemption under this subsection, an owner must personally appear, sign the bm�Idi g 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. Signed and acknowledged on this c2O
day of ,To/ of20o7//.
OwnerfKilder Signature
STATE OF FLORIDA
COUNTY OF S� lil `2p(ANYpG�
The foregoing instrument was acknowledg_ed before me this day of
by G who is personally known PA`- go Of F/oN Vq
produced `` � as identification °'�aii°��` Aiy- issi�iaa-Np GH/V
y Commin 9 GGrary pub/
\ 1 1 Gcrcb ssion 2;,o u is
A�V��l �� `L I I �: . erg 20 Zir0.9
Signature of Notary Type or Print Name of Not (Seal)
es
Title:Notary Public Commission Number G( �1
I
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
C I-I;A R LGs Lowe E(F c-rp,1G , 1_W C.> have agreed to be
(Company Nameadividual Name) STc-pH Ew FE R R E I Rai
the E LeLTR I CAL_ Sub-contractor for
(Type of Trade) (Primary Contractor)
For the project located at f}b 2 5 S, TN D)A N R i ye k- D 2, , �-o g-T pi E2�.0 , .
(Project Street Address or Property Tax ID#)
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.
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CONT SI ( ua SUB-CONTRACTOR SIGNATURE(Qualifier)
PRINT NAME PRINT NAME
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER ,p
State of Florida,County of f q f, State of Florida,County O�S�
The foregoing instrument was signed before me this 2-0 day of The foregoing instrument was signed before me this J_�1_day of
2Q _,by SR _ / " J1AW 2021 ,��� h lJ by\ 5 L� \W
who is personally known or has produced a L V who is personally known)0—or has produced a
as identifica' n(. as identi ca'
STAMP STAMP
Signature of Notary Pub c. Signature of otary Public
K-1 no, onzon
Print Name No Print Name of Notary Public
ELLEN VAUDN
e° ��SState of Florida-Not
Commission # GGMy Commission October 22, 2 s+fto Notary Public State dfbride
+P Sabrina M Arrington
M
Revised 11/16/2016 �j dr Expires OW�2023 279