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' ]�IS,CLOSIIRT STATEI�;NT FOR OWNER CITY OF ZEPHYRHILLS BU=LDINC DEPARTNlEPITT I, Y'1 1-� ��`r��'�`� have read and fully uaderstand and agree to the p v3sioas of ths:s ins�suaiezit: The undersigaed states aad affiarms that he or she is desirous of coszstructing, reaovatiug, adding to or reroofing his ar her owa domicile, that he ar she � actually occupies, or,v�rill occupy by said domicile, aad same is not fox rea�, lease or sale. That he or she sha11 camply urith the follcwiag conditioas: �� 3. Tha� tha awn.er and he or she aloae shall act as the builder for all phases of � constructioa. � � 2. Tha� the owner wi11 camply v�rith all provisioas of�the City of Zephyrhills � ordinaaces aad codes pertiaent �o the buildiag. � 3. That in �he event various phases of aonstiructioa are subcon�rac�ed, he will eagage ouZy properZy Zicensed subaontrac�ors aad wilZ personalI.y supervise such work. 4. That ia the eveat the SuiZdiug Taspeator shall require correetioxis ta be made, the owner will assvme full respousibility to insure they are made, aud upon completion wi11 call for a xeinspectioa before praceediag with t�he buildiag. 5. That the owner" shall assvme. �full resgonsibili�y far the eaastructian aad wi31 aot expeat supervision of his work from �he City�of Zephyrhills 8uilding Departmeat. 6. That prior to fiaal iaspection aay additional fees, includiag reinspectiaa fees, must be paid in �ull. A writtea reque�t from th3s office shall canstitu�e aa afficial uotice to pay additional fees. 7. That the owner sha11 camplyr with all City, State and Federal. laws ia regard ta saaial securityr workmal�rs compensation, I.ien laws, etc. , where applicable. 8. That the owaer shall camply with all the safe�y codes issued by the Florida Industrial Commission. 9. State law requires coastruatioa to be doue by Iiceaa.sed contraetars. You have appl3.ed for a perm3t under an escemption �a that law. �he exemption allows yau, as �he o`vner of your property, to aet as your own cantacactor with certaiu restrictions even �hough you do aot have a license. You must provide direct oasi�e supervision of the constructioa yaurself. You may build or improve a one-�amily or two»famiZy resideace ox a �arm autbuildis�.g. You may al.so build or improve a commercial buildiag, provided your costs do aot exaeed $75,000. The buildiag or resideace must be for your owa use or occupaacy. It may aot be built or substaaa�tially improved far sa].e or lease. If yau se].l or lease a buildiag gou have buil� or substantially impraved yourself withixi 3 year after the ooastruction is complete, the law wi11 presume that you built os substaati.ally improved if foz sale or lease, which is a violatioa of this exemption. Yau may nat hise an unlicensad person tio ac� as your coa�ractar ox to supervise people working on yaur building. It is your responsibility to make sure tha� peap3.e emgZoyed by you have liaenses reguired by state Zaw and by county or muniaipal liceasing ordiaanc�s. You may not delega�e the responsibility for supervisiug work to a licensed aoatractoz who is not Iicensed to perform the work beiag daae. Any person waarkiag on your building who is aat liceased must work vader �rour direct supervisioa aad must be emploged by you, which meaas that yau mus� deduet F.I.C.A, aad w3thho2c3ing ta�c � and provide warkers' compensatian fox tha�. employee, all as prescribed by law. � Your construct�ioa must complg wi.th a11 appZicable laws, ordinances, buildiag j oodes, aad zon.ing regul.atio�a,s. , • � � - - „ O�+tNER'S SI URE \,�, 'M�r� ,r-�, DATE � —"'� - l� ' ADDRES S �-� 4`~►� V�...r��.,*,..- � PIiONE 1`~�� '"°��.�_-'� i"1t {�A WITNESS PSRM=T #