HomeMy WebLinkAboutpermit application (3) Planning&Development Services Department
COUNTY Building&Code Regulations
s R
I r 2300 Virginia Avenue
Fort Pierce,Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S.489.103(7)EXEMPTIONS
State Iaw 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 applica
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 how to me
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 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
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 medic
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 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 terms of the owner/builder exemption shall be reported by the Building and
Zo ' g Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of i of 20 J_j_,L.
Owner/B49der afar
STATE OF FLORIDA
COUNTY OF
The fo going instrument was acknowledged before me.this_�day of
by who is personally known to me,or who has
pr duced �� 4 co 'aS "}��} a(n' 1� asident' c ia�,n�r, `"`
LASHAHNA INGRAIN
Notary Public-State of Florida.
t afore of Notary *Te r Print Nam fNot .; My Comex�}(es Dec 20,2018
r+ 'oe� Comm Assn.FF 177249
Title:Notary Public Commission Number ���''> F�,�`'' Bonded Through National Notary Assn.
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SLCPDSD Revised 0511512414
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Applicant has been advised
No structures
can be erected within any easement or,
light of way unless Otherwise
Applicant initials