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<br />OWNER-BUILDER AFFIDAVIT <br /> <br />BEFORE me, the <br /> <br />) <br />) <br />{~ M \ <br />undersigned authority, personally appeared a. E. QccfA.S <br />, who being by me first duly sworn, under oath, deposes and states <br /> <br />)TATE OF FLORIDA <br />~OUNTY OF PASCO <br /> <br />'IS follows: <br /> <br />I do hereby swear/affirm: <br /> <br />That I own the property described as <br /> <br />z.~pl\yrl\' \lS <br /> <br />3q :~{JO ~ # <br />pL- ~ ~6c.td.- <br /> <br />.r; ve. <br /> <br />Disclosure Statement <br /> <br />State law requires construction to bp- done by licensed contractors.. You have applied <br />:or a permit under an exemption to the law. The exemption allows you, as the owner of <br />four property, to act as your own contractor even though you do not have 8 license. You <br />lust supervise the construction yourself. You may build or improve a one-family or two- <br />:amily residence or a farm outbuilding. You may also build or improve a commercial <br />)lii lding at a cost of $25,000.00 or less. The. building must be for your own use and <br />lccupancy. It may not be built for sale or lease. If you sell or lease a building you <br />lave built yourself within one year after the construction is complete, the law will pre- <br />;ume that you built it for sale or lease, which is a violation of this exemption. You may <br />lot hire an unlicensed person as your contractor. It is your responsibility to make sure <br />:hat people employed by you have licenses required by State law and by County or municipal <br />.icensing ordinances. Any person working on your building who is not licensed must work <br />.nder your supervision and must be employed by you, which means that you must deduct <br />'.I.C.A. and withholding tax and provide Workers' Compensation for that employee, all as <br />,rescribed by law. Your construction must comply with all applicable laws, ordinances, <br />,uilding codes, and zoning regulations. <br /> <br />That I have read the foregoing, and am aware of my responsibilities and liabilities <br />or construction work on the above-described property and do hereby agree to each of the <br />foresaid stipulations. <br /> <br />FURTHER AFFIANT SAYETH NOT. <br /> <br />([:<C6ct t; - LA (f C (a 5 <br />Owner s Signature <br /> <br />Address <br /> <br />Date <br /> <br />WORN to and subscribed before me <br />his day of <br />0_ <br /> <br />otary Public <br />tate of Florida at Large <br /> <br />My Commission Expires: <br /> <br />rint, Type, or Stamp Commissioned <br />ame of Notary Public <br /> <br />ersonally Known _____ or Produced Identification <br /> <br />----- , <br /> <br />~pe of Identification <br /> <br />;G3053047 <br />