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<br />I I <br /> <br />OWNER-Burr.or.R AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />COUNTY OF PASCO ) <br /> <br />r <br /> <br />BEFORE me, the undcrsighed authority, personally Appeared <br />. whol being by me first cluly sworn, under <br /> <br />~& /l flfr-:5 <br /> <br />oath, depos~s and state~ <br /> <br />as f 011 ows : <br /> <br />I do hereby swear/affirm: <br /> <br />/ <br /> <br />That r own the propertYidescribed IlS <br />0~hily)]I)1 r1' '?'?.JY2- <br /> <br />I <br />I <br /> <br />.J7~o /6 d s-f. <br />/ /2-zt:,... Z/ -ODYD -(X)/Ol) - 0 ZoD. <br />/ <br /> <br />Stllte 1m... r(>quin'!s conp, <br /> <br />Disclosure Statement <br /> <br />occupancy. <br /> <br /> <br />for a permit under an ex em <br /> <br />the law. <br /> <br />to IH~ don~ by ] icensed contnictors. YOll hllve ilppU.ed <br /> <br />The exemption allows you, as the owner of <br /> <br /> <br />your property, to act as yo r own contractor even though you do not have a license. You <br /> <br />Thp building must be for your own use find <br />ilt for sale or lease. If you sellar lease a building you <br />the construction is complete, the law will pre- <br />l~ or lease, which is a violation of this exemption. You may <br />as your contractor. It is your responsibility to make sure <br /> <br />that people employed by you licenses required by State law and by County or municipal <br />licensing ordinances. rson working on your ~uilding who is not licensed must work <br />under your supervis ion and be employed by you, which means that you must deduct <br /> <br />must supervise the construe <br />family residence or 11 <br />bui Iding et 11 cost of <br /> <br />outbuilding. <br /> <br />It may not be <br /> <br />have built yourself within <br />sume that you built it <br />not hire an unlicensed <br /> <br /> <br />F. I. C. A. R.nd withholding tax <br />prp.scribed by law. <br />builrling codes. And <br /> <br />You may build or improve a one-family or two- <br />You may also build or improve a commercial <br /> <br />provide Workers' Cc~pensation for that employee, all as <br />must comply with all applicable laws, ordinances, <br /> <br />Tha t I have read <br /> <br />~oing, and 11m aWilre of my responsibilities and liabiliti.es <br /> <br />for construction work on the above-described property and do hereby agree to each of the <br />aforesaid stipulations. <br /> <br />FURTHER AFFIANT SAYETH NO . <br /> <br />i- <br /> <br /> <br /> <br />d subscribe~ before me <br />day of .... )I(IJ~ . <br /> <br />Print, Type, or Stamp Commissio <br />Name of Notary Public ~ <br /> <br />Personally Known ~r Produ <br />. - <br /> <br />Type of Identification <br /> <br /> <br />5-7l/a /6 r-.!t. s:f. <br />Address <br />UtA,; A.-/I r-I. 3J'rf/z--- <br />\ ?Jb - ;p- os <br /> <br />Date <br /> <br />My Commission Expires, ~~ ~~~ <br /> <br />_J <br /> <br />~, Jantc:u I. a. <br />\~~ My Comm/aeion D01Cl9364 <br />Q; ~ Apr111S. 200cl <br /> <br />PC93053047 <br />