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DJ:SCLOSlJRE STATmmHT FOR OWNER CITY OF ZEPHYRHJ:LLS BO'J:LDJ:NG DEPARTMENT J:, a'}~~ &, J~ e;I.- ~ I-- . agree to the provisions of this instrument. have read and f~~y understand and . . The undersig1;l.ed states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domici~e" that he or she actua~~y occupies, or wi~~ occupy by said domici~e, and same is not for rent, ~ease or sa~e. That he or she sha~~ comp~y with the fo~~owing conditions.: ~. That the ow.D.er and he or she a~one sha~~ act as the bui~der for a~~ phases of.. construction. That the ow.D.er wi~~ comp~y with a~~ provisions of the City of Zephyrhi~~s ordinances and codes pertinent to 'the bui~ding. That in the event various phases of construction are subcontracted, he wi~~ engage on~y proper~y ~icensed subcontractors and wi~~ persona~~y supervise such work.. That in the event the Bui~ding J:nspector sha~~ require corrections to be made, the ow.D.er wi~~ assume fuJ.~ responsibi~ity to insure they are made, and upon comp~etion wi~i ca~~ for a reinspection before proceeding with the .bui~ding. That the oWner sha~~ assume fuJ.~ respo:nsibi1.ity for the construction and wi~~ not expect supervision of his work from the City of Zephyrhi~~s Bui~ding Department. That prior to fina~ inspection any additiona~ fees, inc~uding reinspection fees, must be paid in fu~~. A written request from this office sha~~ . constitute. an officia~ notice.to pay additional fees. That the ow.D.er sha~~ comp~y with a~~ City, State and Federa~ ~aws. in regard to socia~ security, workman's compensation, lien laws, etc., where applicable. That the ow.D.er shal~ comp~y with a~~ the safety codes issued by the Florida J:ndustria~ Commission. State law requires construction to be done by licensed contractors. You have app~ied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain. restrictions even though you do not have a ~icense. You must provide direct onsite supervision of the construction yourse~f. You may bui~d or improve.a one-fami~y or two-fami~y residence or a farm outbui~ding. You may a~so'bui~d or improve a commercia~ bui~ding, provided your costs do not exceed $25,000. The bui~ding or residence must be for your ow.n use or occupancy. J:t may n.ot be built or. sUbstantia~ly improved .for sale or lease. J:f you sall;or' lease a building yotihave built orsubstantia~ly imp~oved your.se~f within 1 year after the construction is complete, the ~aw will presume.that you built or substantia~ly improved if for sa~e or lease, which is a. violation of this exemption. You may not hire an un~icensed person to act as your contractor or to supervise people working on your building. J:t is your responsibi~ity to make sure that people employed by you have ~icenses required by state law and by county or municipal licensing ordinances. You may. not de~egate the responsibi~ity for supervising work to a licensed contractor who is not licensed to perform. the work being done. Any person working on your building who is not J.icensed must work under your direct supervision and must be employed by you, which means that you must deduct F.J:.C.A. and wj,thholding tax and provide workers' compensation for that employee, al~ as prescr:ibed by 1aw. Your construction must comply with a~~ applicable laws, ordinances, building codes, and zo:c.i.ng regulations. SJ:GNATURE ~'eZ- ~.t#~I/h~ DATE 0 -17 - 0 ~ ~;cp.1 W6,~~ 01' Or' .2IWk "JCl5<1:J- .--1_'7~- _00 . 2. 3. 4. 5. 6. 7. 8. 9. OWNER'S ADDRESS PHONE r WJ:'l"NESS PERKIT #