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2018
PI a min & Development Services Department ST. Lu
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t ( N Building & Code Regulations C1e Ca ►1►lttln
• • C� '-� •2300 Virginia -Avenue, . -_ ......RECEI1f
Y Fort Pierce, Florida 34982
�a Met� i (772) 462-1553
C FEB 16 2018-
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489.103 (7) EXEMPTIONS ST, Lucle County, Permitting
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, ion -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 for 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; if is
your responsibility to make sure that people employed by you have licenses required by state 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 lica�le
laws, ordinances, building codes, and zoning regulations. Initial ' �//
I understand that the building official and inspectors are not there to design or give advice on ho to t _
the minimum code. Initial �.
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
All
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 liab fqr he
cost of the license. Initial
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I understand that if any person that is unlicensed al d uninsured gets injured on my construction projecj -
they may be entitled to workmen's compensation. I could b'e held liable for all doctor, lawyer and relatepy medial
cost, which could. include loss of wages during recovery from their injury. Initiali--
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 terns of the owner/builder exemption shall be reported by the Building and
Zoning Departure the Florida State apartment of Professional Regulation. Signed and acknowledged on this
day of � of 20 �
� OwnerlBuilder Si afore
STATE OF FLOW
COUNTY OF
L) CE---
Th foregoing ins t w acknowledged before me this day of 20 ,
by� &S 11 1 who is personally known to me,.or who has
nrnrluned, t C 11 — i as identification.
Signature of NoW
Title: Notary Public
Type or Print Name of Notary
Commission Number
.. (Seal)
SLCPDSD Revised 05115/2014 R E N S. N I E L S E N
Commission # FF 115637
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-°- c My Commission Expires ,
June 12, 20118