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D:ISCLOS1JRE STATEMENT FOR OWNER C:ITY OF ZEPB.Y1Ul::ILLS B'O:ILD:ING DEPARTMENT :I, J-"" / .5 S P e /1/ c Eft!... have read and ful.~y understand and agree to the pr~isions of thi's instrument. The undersigJ;l.ed states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own damici~e~< that he or she actua~~y occupies, or wi~~ occupy bY' said damici~e, and same is not for rent, ~ease or sa~e. That he or she sha~~ comp~y with the :Eo~~owing conditions,: ~ . That the owner and he or she a~one shaJ.~ act as the bui~der 'for a~~ phases of ,. construction. 2. That the owner wi~~ comp~y with a.J.~ provisions of the City of Zephyrhi~~s ordinances and codes pertinent to 'the bui~ding. 3. That in the event various phases of construction are subcontracted, he wi~~ engage o~y properly ~icensed subcontractors and wi~l personally supervise such work.. 4 . That in the event the Bui~ding :I:c.spector sha~~ require corrections to be made, the owner wi~~ assume ful.~respons:i.bi~i ty to insure they are made, . and upon comp~etion wi~i cal~ for a re:i.nspection before proceeding with the bui~ding. 5 . That the oWner shal~ assume fuJ.J. respo:a.s:i.bi~i ty for the construction and will not expect supervision of his Work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in fuJ.l. A written request from this office shall ,constitute' an officia~ notice,to pay add:i.tiona~ fees. 7. That the owner shall comply with all city, State and :Federal laws' in: regard to social security, workman's compensation, lien laws, etc., where applicable. 8. That the owner shal~ comp~y with all the safety codes issued by the :Florida :Industria.J. Commission. ' 9. State ~aw requires construction to be done by ~icensed contractors. You have applied 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 license. You must provide direct onsite supervision of the construction yourself. You may bui~d or impr~ea one-fami~y or two-family residence or a far.m outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. :It may not be built or, stibstantial~y improved 'for sa~e or lease" :If you seal ;or' lease a bui~ding you. have built or substantially ini:pr.oved your:8elf wi tldn 1 year after the construction is comp~ete, the law will presUme.thclt you built or substantial~yimproved if for sa~e or lease, which is a violation of this exemption. You may not hire an ~icensed person to act as your contractor or to supervise people working on your building. :It is your respon.sibili ty to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate 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 licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax' and provide workers' compensation for that employee, all as prescribed by iaw. Your construction must comply with all appli-cable laws, ordinances, building codes, and zo:c.i.ng reguJ.ations. ' OWNER'S SIGNATURE ADDRESS :::;- Cl '-I i R '1 c-. S.,- PRONE >ri:~ . ? ~ '2 ~ ~ 2? 8 DATE Z <i!.~ h.'fJlh f I { s I '7-1 ?>":{~~:1.. r W:ITNESS PERMIT #