HomeMy WebLinkAboutOWNER BUILDER AFFIDAVIT (2)Building &Cd& lKea
F4t'Pler Fld!W� 34 _m , M,
(M)44MITM, FEB 3'2010-
1
,,OWNERBUILDER Ag#tDAVlTDISCLt)StJ#E STATEMENT'
F.,
S. 485.103,(7)'EXEMPTIONS
State law re p
quif&s cofistruction,to-bedoncoby licensed.contractors., You,haVd-,Ap, lied for apermit under an
licensed �j
x _ 8; 4$.YoUr own �con r even I
exam pdoin-to1hat you as�,the owner o.,your property;
yoU do not 6vealicenseYou must provide _direct, ' on -site - W 41-oftofthec.o_fistructidn..yourselfY6 gs- two family residence. for .-yo4r, use, and.occup
aPPY7 You--
y'o 1 0
�11
rfi*y,Ws6bQd'-brjm�� rove a �bmmerclal'buflcling,it a cost not vxceeding $75,00100 as.16ng,ii it is for our F?
occupancy Y94 16rihe- pqrjmf, W f.
use or oqcq '�ayn `66d,01_4m said _g
r o selling or easine.th.9 bui in
If you -sell or leasea4uilcling-,yoti have builf'or improved Mififil oneyear `after construction is cio'Mipletes then a
ibh_U�a,,Aola_tion ofthis-exemption. ou-
presumri�on,'isc�thatit-Vatsbtiflt runproved fol- h
sale 4, least:, wY
building; Wis,
ma othire-4n'uhlipe dd -act- as your con ctoror supervtse:p I - -wonting on your
y,h_ ps person to
_�qlp e, wo I and by-qQqnty
that e by, you -have ve es-r y �ha, lic-en"s- 'required your responsibility to make sure at people _69 law
municipal licensing ordinances.- You _rRq'not delegate - die responsibility," for supervising work W'a'licensod
w,,p,erP e kbilfi, one. Y sii4cilbn.must comply 'th all le
contractor 'Who, is not We�siea prm 6, mpyVI
wqTI _8d qur cph
ilding.cqdes;tancl zoning regulations. 1W
ordinances, by
jaws,,6rdin
I understand -,that the building official. and" not there kAeAgn-or -- inspectors are give advice: on liow to e� et
the in,Ml-mujh cqoq.Initial
.1. understand that as an owner -builder that ' any ' b6fitiAd dPUtdis *,* ftW_
h b-contraq!qManci 1-must be handled,
"with
a civil cojrt4ith.tli.-idvide4f an,aqoMye This department,,hill-not,nfldigip.-an�.cgn*tdisputes.
.
�co Any work performed -they, are requited 'I understand trial tomaos* any person or,- - MV - lbr- 0
7kefisedin disjurlidon;If some reason n theydo-Ino't possess a licdnse�l•l may beregponsible,And liable fai the
.
cost of the,licefise.. initial
.1 uh clostio that if any person that is unlicensed and uninsured gets injured- on my'construction protect
they may be' compensation, 1,,could ,beheld liablp"kt,'qll doctor,:law
yer medical
cost, which could include lqssof-wages -during ,recovery from ,their inj
ury,,
-this siibstction� o
To,clualif iis-exempt[on under' an.owner , y- fdkitl
n- permit, 'Puc4io' " ati
initial
e above.
application
ther.6y, ac
lerstqnd that any
STATE OF FLORIb'
'Thel
by R
1?J1511qWU4` YL INVa j -Z
Title: Notary Public `
'SLCPDSD Revig,W,05/115.12014
e that 11 have read and understand the above disclosure ,statement, and, that NAer
of the terms of the owner/builder -ekemptidn, "I be rq wdVA, �by the Building and,
rDepartment ,ida Stat j artnit- nt of. ProRegulation Signed and icknowledied,ons this
9, _
of'20, Ik"'.
asidentification.
uSANNAMARIS GNENS
!W-COMW
ION #-GO 022M
Ty,pqorPrint.Namev Notary 16,2620
Commission Number ON
J
I