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01/15/2019 TUB 11!23 FAX 2002/004
01/11/2019 23:26 772462E SLG INSPECTIONS PAGE 03/04
Plamlhrg & Davelapmfut Smrvlcas Dep.rlment
Building & Cade Re. u`
2300 Vhpale Avoxue
Doef M401rsZ SCANNED
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F.S.1119.103 M LUMMONS
State low regelras mnetdmation to be done by Ilamsed mntm=fs. you have applied ibr a per t under an
effimpilan to that Iaw. The eka*OA allows you, as the owner ofymrr propo"Y, to tot as your g0ntra0mr even though you do not have a license. You moat provide diroown at on -she kpervislon of the ooastru don' ureelL You
may build or Improve farm autbuldhrga, a ona4�mily or iwo fim0y ro4idecoe for your use and escupenoy. You
may also build or improve a Commercial building at a coat not exceeding 875,000.00 as long a it is ibr your aces
use or accupanry. You may not b1d14 or improve sold sdrumuras for the pMosas of sellhrg br laming that bullding.
If you sell or lease a building you have built or improved within one year agar oottstntotlon is uomplcta, titan a
presarnpdon is crated that It wag built or Improved fbr sale or lestc, vfth Is a vlolatfon of this exemptioa you
may fret hire en unilcesxed pmaon to act ae YMm, COntftW or to supeMm people working Ce your building It Is
men msponalldlity to make aura that people empioyad by you have licenses rsquhzd by state law and by county or
unldpai If00asing ordinaneea. You may not delegate the respoeIJUftyy for aupa-VISIng work tat a '
ammeter who is not liad cCuto parfbrra the wok being done. Yore construction MU39 Camply, with 91 le
lawn,ordinance, building cedes, end Zoning MIUN ML IoitW
I understand that die building of6ahrl led 111000102e ate not them to design or give advice ea how a< rho minimum rode. Initial I understand that as Be mvnar•bu{ldar gut any mntreet disputes with eah.eostraemra and I moat be ad
In a Civil court with the advice ofan attorney. Thla department will net mitigate any mnaees dlaputea.
Ialtfal
I understand that If I companeata any person or Compaq fop work patfoemed they are reAabithle
licaseed in thla judsdictton. If mrsome reason they do not pose= a 110vaec, I may be responsible and
coat of the license, bow
I understand that if any person that Is tndfomead and unmarred gets injured on my cc do
they May be died 10 wmJmwt's mmpaneagoa. I Could be held liable fbr all. demon lawyer end MI led1taal
mat, which could facladsloss ofwagpclerics Movarytam their
r�tuy, Initlnl
To qualify for ids exemption under this aubsedtfan, as owner must paraoaalfy appear and alga the bugdleg
pemtitopploation and Initial the above
I hominy uekmwledge that I boa read and understand the above &clam atatemant and fhat I fmaw
ugduatand that tug vlotstlab of the term of the ownl[PbstlldIt exemptionAdl be reported by the Bulldlag and
Zoning ay of_ eau_ to thn Floods lkram RepaAmant of FroPbsalotrel Regui�lda, glgrtad d aeknoxladgW on this
li dayoPUAofZlt f °J, (� A / /n
STATS OF FLQNDA
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fbdfhramethis �r daY �20
_who Is personally inrosssr me, or *he has
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