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<br />STAn. OF F LOR IDA )
<br />COllNTY OF I'ASCO )
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<br />l'p.n5011l1' I y npp~nn~d ~v:i-
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<br />OWl \-)0 )~_
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<br />BF,FORI.: m!>., thf' lllld"I'~~ i f,1Ip.d
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<br />nil I hIli" J ty,
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<br />,,,ho hf' i lip, hy '"'!
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<br />f j rs I du I Y SW001, und!>. r on lh,
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<br />derosn~ "nd ~Lntp~
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<br />n s r nIl n,,!~ :
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<br />1 d n h!>. r e h y S I,' n n I' / n r f I nn :
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<br />Thnl I 0,...11 thn propP!!y d,,~c,'Jbnd ns
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<br />DC) -!) &, - dl - [b;2o .- oo5W'- OO~ }
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<br />Dlsclol'lllrc Slnt!".mnnt
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<br />Stntn 1m, l'PfJllirp~ cnw;lrllcl.lol1 to t,.! c\",," hy Ilcnn~ed cOlllrllctors.
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<br />YOll hn':" flrl' II pd
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<br />. fn!" n pn n111 t 111](1(' ,. fill nxpmpt i nil 10 thn 1 'Jh'.
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<br />Thf' ex~'"rtloll 0110W5 you, n5 th~ ownnr of
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<br />YOllr pl"(lp!>.rty, Lo nct.. ns your m...1l eOlltrnctor even l:h01.lp,h yon do 1I0t hnvn n J .lennse. YOII
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<br />f n III il Y n~ ~ j dell c,~ 0 r 11 f n nn 011 I h II j I d .III P, .
<br />building;>l n cost of $2r;,OOO.on or less.
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<br />~ou moy buIld or improve n one-fnm!ly or lwo-
<br />You moj' nll'lo blllld or improve n eommercinl
<br />Th,. buJldIng must be! for YO\lr own US!? find
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<br />,"w:t :~lIl'"rvj~e th" cn.Il~~':nll:tjoll YOllrsnl f.
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<br />0I;':1Ipl1ney.
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<br />I t III n y II 0 t h n b 1]i It for s n I n or I (! 115 e .
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<br />If you sell or lense n buildlng you
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<br />hovn ""UI; yoursp.lf h:Jl1dll orl('. yn'lr nfter the cOlIstructJon'ls complete, the lll\~ will pre-
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<br />~lImp. t:hnl you bll;ll:i(- for ~nl" 01: l'~o!5n, which ~5 A violnl::loll of l:his exemption.
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<br />You moy
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<br />nol ldrp nil 1Jn.1jr:cw~pd p"rson ns your conlrnctor.
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<br />It :I~ youi rn~ponslbllity to moke s0rn
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<br />tklt I'"opln pmploy!>.d hy YOll hn'J" lieI'll!':"!': fI''1ldred by Stote low ont! by County or m1Jnfcipnl
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<br />lic"ns;IlR onlinrJnens. Any pnr~r)11 working on your huIlding who:ls nol li.censed must wark
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<br />under YOll" sllpcrvis.ian "nd ml1~;L he employnd by you, 1...ldeh meons thot YOI.I must d~r.lu,:t
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<br />r. f.e.A. Ilnrl I,'ilhholding t.[lX I1ml pravldn Workers' C<'"1Ipnnsntion far thot employe"!, olios
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<br />f)Jpscrih"d by 1m,'.
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<br />YOllr cons! rllclioll IIlUSt comply \dth nll nppli.cllble Inws, ordinnnccs,
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<br />hlli '(!;n$~ c:ldns. rind 7.cniJ!g ."!f!.,lI.,t.;oll:;.
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<br />Thnt.
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<br />hl1vP ""nrl t.ht' rorr'r,o;ng,.ond nm OI"nrn of my responslhilities onr! Ilnbilitil's
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<br />[(11" constrllctian wor\r on U". nhovf!-dcscrlhnd propl'rly nnd do herehy ngr('.(! to efleh of lhf!
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<br />11 fr.HI'SI1 ld sl: iplll nl i ,HIS.
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<br />FUIUll E H ^FF J Atn SAY ETIl NOT.
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<br />. Js1 V 0'-"1
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<br />Owner's Slgnntu e
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<br />& I D~ 1;)1.1- o~eef
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<br />Address
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<br />Ze;phyrh,'JI-s)-EL- 33577)
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<br />DatI'
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<br />S\';(,JHI-.J tp I R"d S uk: e r Ifk' ) 'r! Jq' . f O,!' f11P
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<br />C~~}~~~_~~_!2Jk_~~t)?;1 i1/'~~ ~L
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<br />NnLnry""blle
<br />SLnLn of Floridn nL J.nq~"
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<br />lIy Commissioll '~xrIrl's:
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<br />('rillt, Type, or Stnmp Comm.l!';s.lonl'r1
<br />Nnm~ of Notnry Puhlic
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<br />!'prsolllllly Known
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<br />or Prorlucnd Jdelltificntloll
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<br />c~,P":'!~ MONBARREN
<br />N("t~'.! '~lIc - State of Florida
<br />Mv c"'''';'.-,'..Ion Expires Apr 23. 2001
<br />C"'Tlmlsslon * CC640942
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<br />Typn of IrlplltifienL10ll J2&ctt :2.r2_,:)L{ -7&Y<3CY ~ 'J,J-'d-Q
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<br />rC9JO~30" 7
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