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D:ISCLOSU:U: S'l'ATBIID"l' J'01 0Wl0DI. C1:T'!' OJ' ZDIIYJt1ItLLS BVn.DDIQ DDUTIII:R'1' I, &~~ ~(m~ bave ~ead. azul fully underatand. ad. agree to the proviaiOll8 of ~. 1zuJtrwaaat. ~. Ull4ere:Lp-S atatea Imc'l affi:rml!l t:hat he or e:be ia el8airou.s of ecm8t.ruc:t:I.Ag, renovat:-iDg, adding to or ruoof:L4g- JUs or her OWD. damici1., Chat' be or 8U aetua11y occupie., or will ooaupy by 8ai4 ~cil., aad aame is DO~ for rel\t, lea8e or a.le. 'rhat he or llhe shall comply with ~ f"o11owiD9 Couc:U.ti0A8; 1. That the OtfDer aD4 be or .:be .1cme aha11 act .s ~:be bu:i.lcSer f=- .11 pluulea of COD.8tru.cti= . 2. 'l'J:aat 1:Ae owner wi11 eClllply w1 th all provbiollB of t:ha City of Zephyrhilla ordinara.eee and codes pert:i.Jwu.t to the bui1ding. :3 . "l"hat l.za the eveat '9'aZ'ioWl plaase. of COUtruetJ.OA are 1lUbc000tracted., he nIl ezag&ge ora~y properly l:t.e....ed 8ubc:OAtrac:toz'a IIII.d wil1 personally supervis. such work.. 4. That iA the 8V8Ilt the Building Inqeeeor ahall requ;i.r. oorr.ot:icm.a to l)e raacIe, the OWDAtr wil~ a.BUIIltl fu11 re8pO!:UJ1.bility to iJulure t:hey are made, an4 upOA oompletiOll wi11 call tor a reiA8pec:tioza before proeeed.:U1g' w1. th the buildir&g'. 5. '.r1:I.at the Otmer .hall aaa1lllUl fu11 rell1M=8lJ)ility for the ooraa~otioll aJ1d. will. AOt expect su.per'V'isiOll of M8 work fro-. the c.i.ty of ZephyrJ:l1.11a Bu1.lcliAg Depart:mea.t. 6. TJ1at prior to fillal im.BpeotiOll any ad.cI1.t10Jial f.... ia.aluc:J.ing' reilltapect10u fe.., 1IlUIIt: be paid ill full. A wri tteD. requ.aat fram this office 8hall c0Il8tituee aD official AOti~. to pay additional fees. 7. That the OWAar aball oamply wi t:h .11 C1 ty, State aDc1 J'eclara:C 1... ill regard to .ooial securi t:y, worJaaaa.' 8 cOllpeAaatioza, litlll 1awa, .tc., wbere applic:ul.. 8. That the OWD..r aball CClllPly with ul t:he aafety codes issued by the J'lorida IDdustr1.al commi..iOll. 9 . Sta t. 1.. require. eOl18t::t:'Uct1oD to be c1oa.e by liclID.a.d coa.tractors. You have app1ied for a pena.1 t under 811 8Z8111pciOll to that 1..w. "the exemptioll allowB you, .. the 0WJI8Z" of your property, to act: .. your OWA oOlltrac~or with eertaJJ1 r.atriotiOllB 8'Y8Il t:ho11g'h you do ;GOt bav. . liotlllse. You. lIlIUJe prov1de cUrect 0Il8i te .uperviIl1OD. of the cOAatruoticm. your..1f. You aay buJ.14 or improve . cme-fam:i.ly or two-family r.sid.m1ce or a tara out:!>uilc1i.11.sr. You. may a1810 bu:LlcJ or improve a ccmaaercia1 l:ndld.1ng, provicJed. your oost. do not excee4 $25,000. The bui1diZlg or resic1eAc:. muat ba for your OWD. u.se or OCCUPaACy. %t may DOt: be built or sUb.tantially imprayed ~or 8ale or 1..... Zf you ae11 or 1eaee a buildiDg you ha'V'e tnJ.i~t Or 8W:l18ta1ltially improved your.e1f within 1 year after the COI18eru.ct10D 18 complet.. tba 1._ wi11 prelJ\Uae that you built or lIubstaAtial1y improve if for .a1. or leue, ....JUcIA ia . v:LoJ.atiOll of t:hie 8Xlllllption. You may :a.ot hire all lIAlic:8ZU1ac1 persOll to act aa your C:OAtractor or to 8'Upe1:"V'i8e people workiDg 011. your bui1dillg'. It 1a your r.spoa.aibility to make sure tlAat people employed by you ha"e l1ceG8es required. by atate 1.. aDd by OOUD1:y or JIlUDicipa1 1ioea.9ingo orcUAaDc... Tou may IlOt de1egaee the reepcmai.bili t:y for 8u;pervisiq work to . lioln1llK cOIltr.ctor who is AOt 11.C...8ed to perform the work being' dOll.. A:Qy persOll work.iq Oil your bui1.ding who i. D.Ot liollDsed Ia1UIt work under your cUr.ct auperviaicm IIDd. must be employed by you, wh1.ch meallS that you muat c1educt P.I.C.A. and withlaol4ia.g tax &JUS pZ'OYide workU'.' c:~---.tiOJl for that 8IlIPloyee, all iUl pr_oribacl by law. Your ccmatruoticm. must comp1y with all applicable 1awa, ordiAaDu.a; hu:Lld!J19 cod.., and l:oJ1fng re tiOAa. OWJ1D'S AMJUSS PBWIB DATE B~z...., / /-'/,zJ ~ 1fl:TN.8SS PBIUIJ:'l' . l 0 d 9G8voON SllIH~AHd3Z jO AllJ ~V68:l! 800G o8t'PO