CITY OF EDGEWATER
BUILDING DEPARTMENT
104 North Riverside Drive
Edgewater, Florida 32132
HOMEOWNER AFFIDAVIT
Phone: (386) 424-2400 X 1514 FAX: (386) 424-2423
Applicable only to owners acting as their own contractor
DISCLOSURE STATEMENT
OWNER ACTING AS OWNER-BUILDER PER FLORIDA STATUTE CHAPTER 489, SECTION 489.103 AND AS AN ASBESTOS
ABATEMENT CONTRACTOR PER THE FLORIDA BUILDING CODE (FBC) SECTION 105.3.6
PROPOSED CONSTRUCTION: ☐ NEW BUILDING ☐ ADDITION ☐ REMODEL ☐ OTHER
Owner Name (As shown with Property Appraiser)
1) I understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit
under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor
with certain restrictions even though I do not have a license. Initial: ______
2) I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction
and is not hiring a licensed contractor to assume responsibility. Initial: ______
3) I understand that, as an owner-builder, I am the responsible party of record on a permit. I understand that I may protect myself from
potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also
understand that a contractor is required by law to be licensed in Florida and to list his or her license numbers on permits and contracts.
Initial: ______
4) I understand that I may build or improve a one-family or two-family residence or a farm outbuilding. I may also build or improve a
commercial building if the costs do not exceed $75,000. The building or residence must be for my own use or occupancy. It may not be
built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or
leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease,
which violates the exemption. Initial: ______
5) I understand that, as the owner-builder, I must provide direct, onsite supervision of the construction. Initial: ______
6) I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence. It is my responsibility to ensure that the persons whom I employ have the licenses required by law and by county or municipal
ordinance. Initial: ______
7) I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an owner-builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner-builder, may be held liable
and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or her employees while working on my
property. My homeowner’s insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am
aware of the limits of my insurance coverage for injuries to workers on my property. Initial: ______
8) I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the
work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed
by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers’ compensation for the employee. I understand that my
failure to follow these laws may subject me to serious financial risk. Initial: ______
9) I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and
requirements that govern owner-builders as well as employers. I also understand that the construction must comply with all applicable
laws, ordinances, building codes, and zoning regulations. Initial: ______
10) I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United
States Small Business Administration, the Florida Department of Financial Services, and the Florida Department of Revenue. I also
understand that I may contact the Florida Construction Industry Licensing Board at 850-487-1395 or visit
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