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DJ:SCLOSORB S~___J." Ji'OIl 0I01BR ern OF ZBJ?~ BUJ:LDDIQ DBPARTIIID1T :I, 0 lhl a.r /l)e4 It have read and fu1~y understand and agree to the provisio'Ds of this iDst:rumf;imt. The undersigned states and affir.ms that he or she is desirous of constructing, renovating, adA'h'g to or reroofing his or her own dom:i.ci~e, that he or she actua~~y occupies, or wi~~ occupy by said dom:i.ci~e, aDd same is not for rent, l.ease or sal.e. That he or she shal.l. comp1y nth the fol.l.ow:i.ng COIUti.tions: l. . That the owner and be or she al.one shal.~ act as the buil.der for al.1. phases of construotion. 2. That the owner wi~~ compJ.y with al.J. provisions of the City of Zephyrh:LJ.l.s or"" naUC'es and codes pertiDent to the buiJ.d.iDg. 3. That in the event various phases of CODStruction are subcontracted, he wi~~ engage onl.y proper1y licensed subcontractors and wiJ.J. perscmal.~y supervise such work.. 4. That in the event the BuiJ.ding J:Dspector shal.J. require corrections to be made, the owner wiJ.~ assume ful.J. responsibi1ity to insure they are made, and upon compJ.etion wiJ.J. caJ.J. for a reiDapection before proceeding with the bui1ding. 5. That the owner shal.~ asll'Wlle ful.1 respcmsibi1i ty for the CODStruction and wi1J. not expect supervision of his work from. the City of Zephyrhi1J.s BuiJ.cling Department. 6. That prior to final. inspection any additicmal. fees, iD.c~uding reiDspection fees, must be paid in ful.J.. A written request from. this office shal.J. consti t:ute an official. notice to pay addi ticmal. fees. 7. That the owner shal.1 comp1y with &1J. Ciqr, State aDd Federal. J.aws in regard to social. security, workman's compensation, J.ien ~aws, etc., where appJ.ioable. 8. That the owner shal.~ compJ.y with alJ. the s~ety codes issued. by the F~orida :Industrial. COIIIIBission. 9. State J.aw requi%es construction to be done by J.icensed ccmtractors. You have appJ.ied for a permit under an exeDlPticm to that J.aw. The exemption al.J.ows you.. as the owner of your property, to act as your own contractor with certain restrictions even though you do 110t have a J.icen&e. You must provide direct onsite supervision of the const:ructicm yourseJ.f. You may bu:LJ.d or improve a one-famiJ.y or two-famiJ.y residence or a fa:r:m outbuiJ.ding. You may al.se buiJ.d or improve a COllllllercial. buiJ.diD.g. providecl your costs do not exceed $25,000. The buiJ.ding or residence JIIWIt be for your own use or occupancy. :l:t may not be built or substaDtial.~y improved for sal.e or J.ease. :l:f you seJ.J. or 1ease a . bui~ding you havebu:i.~t or substantial.J.y improved yoursel.f within l. year after the construction is compJ.ete.. the J.aw wil.J. pre&1D8e that you bui~t or substantial.J.yiDlproved if for sal.e or J._e, which is a vioJ.ation of this exemption. You may 110t hire an UDl.icensed person to act as your contractor or to supervise peepJ.e worJd.ng on your bu:i.J.ding. :l:t is your responsibiJ.ity to make sure that peopJ.e empJ.oyed by you have J.icenses required by state J.aw and. by county or DlUDicipaJ. ~ioensing ordiuances. You may not d.el.egate the respcmsibility for supervising work to a 1:i.censed ccmtractor who :i.s not J.:i.censed to perfozm the work being done. Any person working on your building who :i.s not J.icensed must work UDder your d:Lrect supervision and must be emp10yed by you, which meaDS that you must deduct F.:I:.C.A. and withhoJ.d:ing tax and prov:i.de workers' COIIIpensat:i.on for that empJ.oyee, al.J. as prescribed by 1aw. Your construction must compJ.y w:Lth al.J. appJ.:i.cabJ.e 1aws, or";n""'I"f("es, bui1ding codes, and zon:i.ng reguJ.at:i.ons. :: s~~~/~f~~~~ DATE 12-/;'.-0;- PBOIIB ~~L}JlL- PBJUD:T I W:ITRBSS