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<br />OWNER-8UIr~F.R AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF PASCO <br /> <br />, <br />J <br /> <br />BEFORr: me. the undersi.gned authority, personally appeared l<eOf\efh UJLJL,fJ.5 <br />, who being by m~ first duly sworn, under oath, deposns /lnd stAteR <br /> <br />....-l~. fo llows: <br /> <br />I do hereby swearjnffirm: <br /> <br />TltRt r own the property described ns <br />FI 3354 a <br /> <br />SC; 02.. <br /> <br />Rlk <br /> <br />.ST <br /> <br /><...p ~ At (' 'J... I J 1.5 . <br /> <br />Disclosure St8t~ment <br /> <br />StAt~ 1m.' 1"1'C'JlIirp.!'i conntruction to 1,.. don~ by licell!'ied contt"Lictorl'l. You have Ilpp1il:1d <br />for 11 permit \lnder an exemption to the 1 aw. The exemption a llows you, as the owner of <br />your peoPQrty. Lo /lct as your own controctor even though you do not hRV~ a license. You <br />must SUpfHvise the construction yourse I (. You may build or improve a one-family or two- <br />fami 1)' residence orn (orm outbuilding. Vou llIay also build or improvn .a commercial. <br />buill1i.ng i't '1 cost of $25,000.00 or l~ss. Thf' building must be for your own use Rnd <br />occupancy. T t may not h'2 buil t for sale or ladse. If you sell or lease a building you <br />have built yourself tdth!n onp. year after the construction is complete, the law will pre- <br />sume that you built it for saln or lease, which is a violation of this exemption. You mAY <br />not hire an unlicensed p~rson as your contractor. It is your responsibility to make sura <br />that people employed by you have licans~s required by Stllte law and by County or.municipal <br />licensing o~dinances. Any person working on your:building who i~ not licensed must work <br />under your supervision and must be employed by you, which means that you must deduct <br />F.I.C.A. ~nd withholding tax and provide Workers' Cc~rensation for that employee, all as <br />prp.scribf!d by law. Your construction must comply wi.th all applicable lRws, ordinances. <br />hllildinr, codes. ,'\nd :>::::ning ::egul.1tiul.:;. <br /> <br />Thnt I havp. rr,nrl t.he rore~oin~, nnd 11m awnrr. .of m~' 'responsibilities and 1 labi litic~ <br />~or r.onstruction \...ork on tlw I1bovP'-o(ll'icrihf!d property And do hereby llgrep. to eAch of thr <br />ilfoTf!said stiplllaLhjJ\s. <br /> <br />FURTHER AFFIANT SAYEl1f NOT. <br /> <br />ilILI't~ <br /> <br />Owner's Signature <br /> <br />550 :L <br /> <br />g=-;-t.. 5' <br />Address <br /> <br />Z~fJ....'i (L.., II <: F/ :<, ~ ~42 <br />oS /;1 lOft, <br />Date <br /> <br />SWORN to and subscribed before me <br />this day of <br />19_ <br /> <br />Notary Public <br />State of,!lorida at Large <br /> <br />My Commission Expires: <br /> <br />Print, Type, or Stamp Commissioned <br />Name of Notary Public <br /> <br />Personally Known ~ or Produced Identification <br /> <br />Type of Identification <br /> <br />fL tV LJL_~JS7C))BS'D- <br />