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<br />PASCO COUNTY <br />CENTRAL PERMITTING DIVISION <br /> <br />OWNER-BUILDER AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF PASCO <br /> <br />Before me, the undersigned authority, personally appeared {(DbeJ+_W h', -\-\cJy--orG <br />Who being by me the first duly sworn, under oath, deposes and states as follows: <br /> <br />I do hereby swear/affirm: <br />That I own the property described as m ~ Chax i at ~l1..~ k: _ lint ltnbJeJ) , <br />IDCated on D- 'D+ 'In ~c. CbIL~ at 318ID ~..Hilllwp lLot 'lo~ <br /> <br />Disclosure Statement <br /> <br />State law requires construction to be done by licensed contractors. You have applied for <br />a permit under an exemption to the law. The exemption allows you, as the owner of your <br />property, to act as your own contractor even though you do not have a license. You must <br />supervise the construction yourself. You may build or improve a one-family or two- <br />family residence or a farm outbuilding. You may also build or improve a commercial <br />building at a cost of $25,000.00 or less. The building must be for your own use and <br />occupancy. It may not be built for sale or lease. If you sell or lease a building you have <br />built yourself within one year after the construction is complete, the law will presume <br />that you built it for sale or lease, which is a violation of this exemption. You may not <br />hire an unlicensed person as your contractor. It is your responsibility to make sure that <br />people employed by you have licenses required by State laws and by County or <br />municipal licensing ordinances. Any person working on your building who is not <br />licensed must work under your supervision and must be employed by you, which means <br />that you must deduct F.I.C.A. and withholding tax and provide Workers' Compensation <br />for that employee, all as prescribed by law. Your construction must comply with all <br />applicable laws, ordinances, building codes, and zoning regulations. <br /> <br />That I have read the foregoing, and am aware of my responsibilities and liabilities for <br />construction work on the above described property and do hereby agree to each of the <br />aforesaid stipulations. <br /> <br />FURTHER AFFIANT SA YETH NOT. ;( j/_____ <br /> <br />acid wkMn"~ <br /> <br />Owner's Signature <br /> <br />~C\~ D Cflj \-\' \\ l DCr) 2e~"\ \l't-i \\<s) fL 33SLI 2.. <br />Address <br />~/I~00 <br />I Date <br /> <br />Sworn to and subscribed before me this <br />-qot ( 20~. <br /> <br /> <br />6tary, blic <br />- Stat f Florida at Lar <br />My ommission Expires: Z-~/7.-Za:::J7 <br /> <br /> <br /> <br />~, <br /> <br />;)5J7S <br />o 21J9 <br /> <br />.- '. "1; \",\lI~d <br />