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Owner Builder Affidavit
RECER-D OCT 12 2015 . r °.. PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division 2300 Virginia Ave Fort Pierce,FL 34982 772-462-1553 Owner Builder Affidavit— Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under$75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 year after the construction is complete,the law will presume that you built it for sale or lease,which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. 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 ownerlbuilder exemption shall be reported by the Community Development Director to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of , 20 O OUILDER GNATURE STATE OF FLORIDA COUNTY OF S�'( •1.V c The foregoing instrument was acknowledged before me this la, day of 6- 120 , by rb 4,{ k �°� r�� f'� ,who is personally known L_)to me or has produced \ / as identification. PG�v�NO�\o 6 r\Ck `i-1 V S a'TSes Signature of Notar§j Print name of Notary PUe� N°�a�omm��Qo# a Nd�a�y P55 Title: Notary Public Commission Number '.SrAr f�o` SLCPDSD Revised 4/11/2011 St.Lucie County Owner Builder Affidavit-Electrical Contracting RECEIVED OCT 12 2015 Planning&Development Services Department - Building&Code Regulations t © r o 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. 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. 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. 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 I understand that the building official and inspectors are not there to design or give advice on ho meet 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 I understand that if I compensate any person or company for work performed they are quire to be licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and lia for the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my const ion roject- 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 To qualify for this exemption under this subsection,an owner must personally appear and s' the ilding 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 day of of 20 -- Ow ui r Signature STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this \a,_day of ,20 , by *144V,, "(g-I v��ro'1� who is personally known to me,or who has roduced as identification. pEpNNP�IgEMS Q {Flo C\%N^o,\6,1 Slate° Zoe 6 Signature ofNotar Type or Print Name of N toP Y P�Q�c,, Nota�Y PmeE( ��)�e gSaZg� Title:Notary Public Commission Number =P'• a�_My r ksS%oo a ona\h6l assn. b SLCPDSD Revised 05/15/2014 ... ''�