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04-3556
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04-3556
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Last modified
3/6/2009 3:22:10 PM
Creation date
2/8/2007 9:25:36 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
04-3556
Building Department - Name
PECKENSHNEIDER,BRET
Address
5251 5TH ST
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<br />OWNER-BUII~ER AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF P.'.SCO <br /> <br />"(.. <br /> <br />BEFORE me, the <br /> <br />undersigned authority, personally appeared /Yc.'" ~. ~t:.Ja,^rd4.1& ;~ <br />, who being by me first duly sworn, under oath, deposes and states <br /> <br />2.S follows: <br /> <br />I do hereby swear/affirm: <br /> <br />'I That lawn the property described as fQJ1')tJ. ~tJ .p(cf ~~ /~-fJ 6.J) J <br />/or.'{.f(4 Iff- J;JSI 5~A 5+""1; Z~{llyt'i 14 fJ <br /> <br />Disclosure Statement <br /> <br />State law requires construction to La done by licensed contractors. You have applied <br /> <br />for a permit under an exemption to the law. <br /> <br />The exemption allows you, as the owner of <br /> <br />your property, to act as your own contractor even though you do not have a ] icense, You <br /> <br />must supervise the construction yourself, <br />family residence or a farm outbuilding, <br /> <br />You may build or improve a one-family or two- <br />You may also build or improve a commercial <br /> <br />Quilding e.t a cost of $25,000.00 or l~ss. <br /> <br />ThE' building must be for your own use and <br /> <br />occupancy. <br /> <br />It may not be built for sale or lease. <br /> <br />If you sellar lease a building you <br /> <br />have built yourself within one year after the construction is complete, the law will pre- <br />sume that you built it for sale or lease, which is a violation of this exemption. You may <br /> <br />not hire an unlicensed person as your contractor, <br /> <br />It is your responsibility to make sure <br /> <br />that people employed by you have licenses required by State law and by County or municipal <br />licensing ordinances. Any person working on your building who is not licensed must work <br />under your supervis ion and must be employed by you, which means that you must deduct <br />F.I.C.A. and withholding tax and provide Workers' Cc~pensation for that employee, all as <br />prescribed by law. Your construction must comply with all applicable laws, ordinances, <br />building codes, and zoning regulations, <br /> <br />That I have read the foregoing, and am aware of my responsibilities and liabilities <br />for construction work on the above-described property and do hereby agree to each of the <br />aforesaid stipulations. <br /> <br />'I- <br /> <br />wu~d:t <br />.S' :.rjJ <br /> <br />Owner's Signature <br /> <br />j-fA Sfv,.rt JZ~jjAL{rl j I{;J rl <br />Addres s / J :SS'i.)J <br /> <br />FURTHER AFFIANT SAYETH NOT. <br /> <br />Lf <br /> <br />ct.-f <br />'- <br /> <br />07 <br /> <br />Date <br /> <br />SWORN to and subscribed before me <br />this t+ day of D ~ <br />20 ...J:;l:!. <br /> <br />,"- <br /> <br /> <br />c f) . ~ <br />(. - I~~ L-I'" L <br />blic <br />Florida at Large <br /> <br />My Commission Expires: <br /> <br />c; - J'\ -6') <br />..J <br /> <br />Notary <br />State 0 <br /> <br />k~ ~ G. ''"8 L. ULD-v <br />Print, Type, or Stamp Commissioned <br />Name of Notary Public <br /> <br />.....";~~~:!;:,'"" KAY E. BUCKLER <br />g:fJi.~~ MY COMMISSION # DD 225591 <br />~..~~~:.j EXPIRES: August 15, 2007 <br />""~;R~,r.~"" Bonded Thru Notary Publtc Underwrtt&JS <br /> <br />Personally Known _____ or Produced <br />~L <br />Type of Identification DL <br /> <br />1-------- <br />Identification _____j <br />P 2 <; 2.. d,~-l Cj ~ b 2 ' I ~ ,- 0 <br /> <br />PC93053047 <br />
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