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� � . '� nisc�osmz� sxA��rrr �aR ovar�R � CITY OF ZEPHYRIiILLS BtTILDING DF�PARTMlyNT _. ��/�c 6P�/ L-- �.��^''��C have read and fully uaderstaad aad i agree to the pravisiaxxs of this instrume,nt. The undersigaed states and affirms that he ox she is desiraus of caastructing, renovatiag, addiag ta or reroofiag his or her owa domicile, that he or she ac�ually occupies, or will occupy by said damicile, aad same is aot fos rent, lease or sale. That he ar she sha23 comply �rrith the fallawiag caziditioas: 1. Tha� the owaer and he or she aZoae �shal]. act as the builder far all phases of constructioa. 2. That the owner wa.11 camply vaith all grov3sions of the City af Zephyrhille ordiaances and aodes pertiazeat to the building. 3. Tha� in the eveat variaus phases of coastruc�3on axe subcoatrac�ed, he will engage oaly pxoperly liceaset3 subcoutractars aad will persoaally supervi,se sueh woxk. 4. Tha� ia the event the Suilding Iaspector shall require eorxections �o .be made, the owaes will aeeume �ull r�spoasibility to insure they are made, aad upoa completioa wi].l call �or a reiaapec�ion before proceeding with the build3.ag. 5. Tha� the owaer sha2l assume fu12 respoasibiiity far the cos�struetion aad will aot expect superva.sioa of his work fxom the City af Zephyrhills Suildiag Depastmeat. � 6. Tha� prior ta fiaal iaspection aay additioaal fees, iacludiag reiaspectiaa fees, must be paid in tull. A writ�en request fram this office sha11 coastitute an afficial aotice to gay additional fees. 7. Tha� the ov�raex ahall comply with all City, State and Federal laws in regard ta soaa.al security, warkman's compensatian, �Iien lavrs, etc. , where app2i.cable. S. Tha� the owaer shall comply with all the safe�y codes issued by the Florida Iadustrial Commisaioa. 9. State law requires constructioa ta be doae by lic�ased coatractars. You have applied for a perrnit wsder aa eacemption to that law. The exemptioa allows ycu, as the oc,raer of your praperty, �o act as your av�a contractor �rs.th certain res�rict3.oas evea though you do aot have a licease. Yau must provide direct aasite supervi.sioa of the constructioa yourself. You may build or improve a oae-fami3y or two-family resideazce ax a �arm autbuildiag. You may also build or improve a commercial bu3.ldiag, provided your casts do not exceed $75,OQ0. The building or residence must be for your owa use or oacupaney. It may aot be built or substaatially 3.mproved for sa].e or lease. If yau sell or lease a buiZdiag you have built or subs�aatially imgroved youraelf withia 1 year after the cons�ruction is complete, the law will presume tha� you built or substaatially improved if for sale or lease, which is a viol.atiaa of this e.�cemptioa. You may ao� his� an ualicen$ed pezsan ta act as your con�ractor or to aupervise people workiag on your buildiag. It is yaur responaibility to make sure that geople employed by you have liaens�s required by state law and by county or municipal liceasiag ordiaaaces. You may aot delegate the respaasibility for aupezvia3ng work to a liceased coatracter who is xlot licensed to perfarm the work beiag done. Any persaa warkiag an your bui3.ding who is nat liaensed must work uader your direct supervi.sion and znust be �mployed by you, whieh means that you must deduct F.I.C.A. and withholdiug ta.�c and provide workers' campensation far that employee, a11 as pre�cribed by law. Your coastruc�ioa mus omply with a11 apglicable laws, ordiaan,ces, buildiag codes, and zoaing r atiosas. C�{ OWNER'S SI6NA'PiJRE DATE � �C�I �/'ADDRLSS „� fa p4 PHONE - - S WITNFSS �'ERMTT #