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�r -• �� pISC�QSIIRE STATF•P�'Rfi FOR Qi+6hTER C�TY OF ZBPHYRBILLS �UTLD�i++6G DBPARTP��.' � l� � z. have read and fu11y vaderstaad and agree to th ravisa.oas o his iastrum�,nt. The uaders3gaed states aad affir�s that he ar she is desiraug ot coastructiug, reaovatiag, addiag to or reroofaag his or h�r owa domici3e, that he or she actually occupies, ,or wi11 oacupy by said domicile, aad �aame is nat for rent, lease or sale. That he ox she Bhall camply with the followiag coaditioas: 1. That the owner aad he cr she aloae shall ac� as the buil�er for al1 phases of coastruc�ion. � 2. That the owaer will comply with al1 p�ovi.sions of tk�e City af �ephyrhi3ls ordivan,ces �nd codes �ert3neat to th� buildiag. 3. "Phat ia the eveat various phasee o� coa�truction are subcoatracted, he �rill engage only properly Iiaeased subeanbractars aad will pereoaally superviae auch wark. 4. That ia the eveat the Suildiag Iaspector sha11 require correctioscs to be made, the awaer will assume full sespoasibility to is�sure they are m�.de, aad ugan completioa wiZl ca].I for a reiaspectioa befose proceedixug wit�h the build3ag. 5. That th� owxter sl�all aseume full responsibility for the coastruct3on aad will not e�ect supervision of his s�osk from the City of Zepisyrhille Buildiag I?egartmen�. 6. �'hat pr3or to fiaal iaspection aay addi�ioaal fees, iaeludiag reiuspeetioa £eea, mus� be paid ia full. la, written request from this office sha1Z aoastitute an offic3.a3 aotice to pay additional fees. 7. That the owaer sha22 comply �,rith a.11 City, State sad Fecl�ra,I 1a�nrs ia regard to social secnra.ty, workman's eompensa�ion, 3ien laws, etc. , where appla.cabie. 8. That t]�e awaer sh�l], complg with all the safety cades issued by th� Florida Iadus�ri,al Commissiaa. 9. State la,w reguites constxuctioa to be doae by licenseci caatractas�. You have app3.i�d for a permit under aa exemptioa to that l�w. The exemptioa �llov�s you, �s th� avaaer o� gour pragerty, to act as yaur o� coatraatar vaith aertain restrictioas evea tl�ough �au do aot have � Ziaeas�. You must provic3e direc� oas3te �up�rvisiosa of the coa�tructioa yaurself. You may build or amprav� a one-fasnily or two-fami.ly residlen,c� or a lEasm out�buildiag. You may also build ar imprave a commercial buildiag, y�rov3deei your costs do aot exeeec� $75,000. The buildiag or reBideaae mus� be for ycur owa use or occupawcy. �t may aot be built or substaatially itnproved fos sa2e or 2ease. If you sell or leae�e a buildi�ng yau have built or substaati�l2y iaiproved yourself withia 1 year after the corrtstruction 3s complete, the law will pr�aume that you builb or substantia7.Iy impro�red if far eale or le�se, which ie a violatioa af this eacemptioa. Yau may not hire aa ualic�nsed persoa to act �,e your coatraator or ta supervise people woxkiag aa yaur bui2ding. It is your responsibility to make sure that people employed by you hav�e liceases reqrxir+ec� by stat� law �.nd by covssty or mvaicipal liceasiag oacdiaaaces. You may aot deleg�te the -- respoasibility for supervisiag work to a liceaser� coatractor who is aat Iicensed to perfozm the wask beiug doxie. Aay persoa workiag oa your building .who 3s aot licensed must +arork ummder your dixeet supervisioa �ad must be --,-------'e�loyed by�rouL�c�rhir,��aae—tha��r.osi_��,s�--ded�c�-I�,-�:�.�-�ad-vritish�2-ciiag tax- --_— - ---- - -- and pravide warlcers' campensation for that employee, al]. as prescribed by law. Your coastructioa must comply wi�h a11. applicable law�, ordiaaacee, buildiag eades, aad zoaiag regulatioas. OWNER'S S2GNATURE � DATE L��^ �� , ADLtRBSS + BHONE L�(.�� --�'7 ( ')�T_ WITT2�SS PFiiP9TT # !