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' nzscvosvRr sT�s� Fo� owNsx . ca�r oF �s�e��aL�.s S�TLDIAfiG DEPA3tT�TI.' �. I, � �,.J. /� h�ve read aad fully iia.dexst�aud aud agre� ta the psavisioas of th3s 3.aatrument. The uadersigaed states aad affirms �ha� he or she is desizous o� canstructiag, • seaovatiag, add3ag to or reroafing his os h�r owa domic3le, that he or she actually� a�ccupies, or will 'occupy by sa3st dam3.cile, aad same is uat for rent, lemse oi sale. That he or she sha�l camgly with �he fo7.lawiag aoaditioas. 1. That �he o�mer aandl he ar she a1oa� shall act as the builrler for a11 phases of cons�kructioa. � 2. That the o�mer wr311 comgly with all provisioas of the City af Zephyrhili� oxd3aaac�s and caales pertiaent to th� buildiug. fr� 3. That ian th� evea� various pha�es of aoustruction �re subcoatracted, he w3.11 eagage aal�► pxoperly licensed subcoatractars aad will persaaa].lg supervise such woxk. � 4. That in the eveat the Suildiag Iaspector shaZ3 re+quir� coxrections to be made, the o�aaer will assume full sesponeibility to ia�ure they are made, aad upoa eampletioa wi1l call for a reiaspec�ioa before praceediag with �he bu3.ldiag. 5. That the owaer •shall as�ume fu7.1 respoa�a.bili�y for �h� coastruation aad wiZl aot �ect sup��risioa of his vaork from th� City of Zephyrhil3s �uilding Departsaeat. 6� That prior ta �iaal iaspectian aay addition�l fees, iacludiag xeinspect3,oa �ees, muat be paid ia full., A wsitt�n r�quest fram this affice sha3�. coasta.�ute aa o£ficial notiae to pay additianal .�ees. 7. Tha� th� cswa�r shall comply with all City, State aad Fedetal Iaws ia regaxd to - sociaS seaurity, workman's campensatian, lien laws, etc. , where appla.cable.� � 8. That the as�n�r sha11 comply witlu all the safety codes issued by the Florida Iadustrial Commissioa. - 9. State law requires aonstruation to be done by 2iaeased cantractors. You have agplied �c+r a pezmit uader aa �ac�mption to that I.ava. The escemption �llows �; you, �s the owner o� your property, to act ae your own aoatractox +cvith certai:a � restrictioas evea though you do aot have a liceas�. You mu�t provsda direct oasite sup�ervisioa of th� coastructioa yourself. Ycu may build ar ia►pzov� a oae-family=or troao-family resideace or a fa.rm outbu3.lding. You aiay a3sa bui2d or improve a aammerci�l, buildiag, provided your coats da act exceed $75,000. The building ar re,sideace must b� for yaur owa u6e or occupanay. It may no� be buiit ox substantimlly improved for sale or lease. Zf you s�ll or l�ase a bui.lc�iag �rou have b�ilt c"r sub�t�at3.mlly 3mprav�d ycuzseif with3.a 2 y�ar aftes the coastrza.ction 3s eomplete, th+e i.a�a will pxesume that -yau built ar substaatially ia�praved if �or sale or lesse, wh3.c�s is a violmtioa of this , exemg�tiaa. Yau may aot hire aa uals.cease� persaa to �cti._�s yaur coatr�.etox az �� to supexvise people worki:ng oa you;r bu3lding. It i�s yaur respons3bility ta ` make sure that p�aple emplayed by you have lia+eases required by state Zaw �ad by aaua�y or munic3pal 2ieeasiag orc�inanaesd You may aat delec��te the respansibility �cir supervisirxg taork to a liaea�ed contractor wha ts uot liceased to pezform the work bexag doae. Aay persoa work3ag ou yaur bu33c3iag who is not 13c�ensed must work wnder yous dixect supervisioa aad n►ust be _ e�l�ed b�.�cu��rhi�h_��as—that_-y_a�x-mus�--c?edtact-�.�.�.�:--aa�-w3tizfi�crlxt�ag-tax- --•------- - -- � and provide' workers' compensatian far that employee, sIl �s pxescribed by lasv. Yaur canstruatiaa must c with all applicat>le laws, ordiaar►cee, build3ag codes, aad zaaiag re ti s. OWNER'S SIGNAT �f� DATE � ADDRESS � PSONE va=zrasss �� # _ � i