482 NE 93 St (7)VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
I being the legal property owner, for the property
Located at:
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),„vid I have read and understand the following disclosure
Statement, which entitles me to -krork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEFVTFNT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one- family or two- family residence or a farm out - building. You may also build or improve a
commercial building at a cost of 525,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not Iicensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument
Was acknowledged before me this day of , 20
B who is personally known to me or who has
Produced
Owner
Owner
as identification and who did take an oath.
Notary
NOTICE OF OMMENCEMEN T
A RECORDED COPY MUST BE POSTED ON THE JOE SITE AT TIME OF FIRST INSPECTION
PERMIT NO TAX FOLIO NO
STATE OF FLORIDA
COUNTY CF MIAMI -DADS
THE UNDERSIGNED nereov dives notice tnat improvements will De mace ID certain reai
orooeny. and in accordance with Cnaoter 713. Fionao Statute:. the roiiowino inrormauor,
is bravoed rn this Nonce of Commencement..
1. Legal aescnption of property and streetiaoaress'
2. Description or improvement
3. Gwneris) name and address:
interest in property'
Name and address of tee simple titleholder:
4. Contractors name and adores:
Surety: (Payment bond required ov owner from contractor. if any
Name and adore::
Amount of bond S
E. Lenders name anc adores :.
7. Persons within the state of Fiance oesionated oy Owner upon wnom notices or other documents may de serve 2S
provided by Section 712.13(1)(a)7., Florida Statutes.
Name and adores::
8. in addition to nimsel . Owners oesianat:es tne following Dersonls) to receive 2 copy of tne Llenor'S Not; :e as proviaed
in Section 713.13(1)(b). Fiona: Statutes.
Name and adores ::
9. Expiration date of this Notice of Commencement: (tne expiration date is 1 year from the date of recordinc unless a
different date is specified)
Signature of Owne-
Pin, '.Dwner: Nam:
Sworn to an: sup :cnoeo peTore me tni= _ 02, . 2C
Niiar\ uDG;
LreD2-.._
!-',cores: