Town of Cutler Bay
OWNER/BUILDER AFFIDAVIT
NAME OF OWNER/BUILDER:
LEGAL DESCRIPTION/ADDRESS:
Congratulations and good luck with your Owner/Builder project. Please feel free to call the Building
Department if you require assistance. This affidavit is designed to help you avoid common problems that
Owner Builders often encounter. Please read and initial each of the following items.
I do certify that, as a Owner/Builder, I understand and acknowledge the following:
1) I am personally responsible for knowledge of all applicable laws and regulations.
2) I will personally reside in the house after completion and the issuance of the Certificate of
Occupancy.
3) Neither I, nor any member of my immediate household family, have made an application for,
or have been issued either an Owner/Builder permit or a Certificate of Occupancy based upon
an Owner/Builder permit (for a single family residence) within the past three (3) years.
4) I will be on the premises either supervising or performing the actual work at all times. I will
submit an accepted form of identification upon request by the Building Department’s agent.
5) I understand that if an inspection is not approved after three attempts, the Inspector may place
a Stop Work Order on the job; and require that a licensed contractor complete the work.
6) I understand that any person whom I may wish to hire to aid me in the construction of my
home, except common laborers, must hold a valid Miami-Dade County Certificate of
Competency or be State licensed contractor. All employees hired by me shall be covered by
Worker’s Compensation Insurance. (Typically Homeowner’s Insurance does not provide this
coverage; Please check with your insurance carrier).
7) I understand all the requirements and responsibilities involved in obtaining an Owner/Builder
permit. I have read and understood the foregoing disclosure, and am aware of my
responsibilities and liabilities under my application for building construction work on the
above-described property. I further understand that failure to comply with all the required
regulations may cause the revocation and/or denial of the permit and /or certificates of
occupancy/completion.
X
Signature of Owner Print Name
STATE OF FLORIDA COUNTY OF MIAMI-DADE
Sworn to and subscribed before me this
day of 20 .
By
(SEAL)
Personally know
or I.D.
