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:I. I-kLro/! DJ:SCLOSOlUI S'l'ATBIIBR".r FOR OWIIBR crrY OP ZBJ?!IDBJ:LLS BUJ:LDDIG DBPAll".rJIID1'l' !ki/ have read and fu1l.y understand and. agree to the provisions of this iDstrument. The undersigned. states and affi%ms that he or she is desirous of constructing. renovating. .......:r(g to or reroofing his or her own damicil.e. that he or she actually occupies. or wil.l. occupy by said &:.dcil.e. and same is not for rent. 1.ease or sal.e. That he or she sbal.l. compl.y w:l.th the fol.l.ow:i.ng conditi.cms: 1. . That the owner and he or she al.one shal.l. act as the buil.der for al.1 phases of ccmstruction. 2. That the owner wil.J. compJ.y with al.J. provisions of the City of ZephyrhiJ.l.s ortH ftBces and codes perti.D.ent to the buiJ.ding. 3. That in the event various phases of ccmstruction are subcontracted. he wiJ.1. engage onl.y properl.y licensed subcontractors and wil.l. personal.l.y supervise such work.- 4. That in the event the BuiJ.diD.g :Inspector sbal.J. require correcticms to he made. the owner wiJ.J. assuae fuJ.J. reapODSibil.ity to iDaure they are made. and upon ccmpl.etion wiJ.J. cal.J. for a reiDapection before proceeding with the buil.ding. 5. That the owner shal.l. aSB1DD8 fuJ.l. respcmsibiJ.i ty for the ccmstruction and wil.l. not expect supervision of his work from the City of Zephyrhil.ls Buil.d.ing Department. 6. That prior to fiDal. inspection any additional. fees. .incl.uding re:iDspection fees. must be paid in fuJ.l.. A written request from this office shal.l. ccmstitute an official. notice to pay additional. fees. 7. That the owner sbal.l. compl.y with aJ.l. City. State aDd Pederal. l.awe in regard to social. security. workman's compensation. J.ien l.aws, etc.. where appJ.icabl.e. 8. That the owner shaJ.l. compJ.y with al.l. the s~ety codes issued by the Pl.orida :Industrial. Comm:ission. 9. State l.aw requires cODStruction to be done by licensed contractors. You have appl.ied for a permit under an ex-.ption to that l.aw. The exemption al.l.ows you. as the owner of your property. to act as your own contractor with certain restricticms even though you do not have a l.icenae. You IIlUSt provide direct oD.Bite supervision of the COD.Btruction yoursel.f. You may buil.d or improve a one-family or two-famiJ.y residence or a farm. outbuil.ding. You may al.so buil.d or improve a cOlBl8rcial. buiJ.d.ing. provic1ed your costs do not exceed $25,000. The buil.ding or residence DlDBt he for your own use or occupancy. J:t.BY not be buil. t or substantial.ly improved for sal.e or l.ease. J:f you se1J. or 1.eaae a . buil.ding you havebuil.t or substantial.l.y improved yourself within 1. year after the ccmstruction is comp1.ete. the l.aw wil.l. presume that you buil.t or substaDtiaJ.l.yimproved if for sal.e or lease. which is a viol.ation of this exemption. You may not hire an unlicensed persOn to act as your contractor or to supervise peepJ.e working on your buil.ding. J:t is your respcmsibiJ.ity to make sure that peopl.e empl.oyed by you have l.icenses required by state l.aw and by county or municipal. l.icensing ord",,?1Pn.,es. You may not deJ.egate the responsibility for supervising work to a l.icensed contractor who is not l.icensed to perform the work being done. Any person working on your building who is not li.censed must work 1UUier your direct supervision and must be empl.oyed by YOU. which meaDS that you must deduct P.J:.C.A. and withhoJ.ding tax and provide workers' compensation for that empJ.oyee. al.1. as prescribed by l.aw. Your ccmstruction must camp]; with al.1 appl.. able l.awe. orlHft=aftces, buil.d.ing codes. and zoning regul.ati 0_ · S ADDItBSS PBORB DATE S- -jj--oj; WJ:T1lIBSS. PBJUD:T #