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<br />DJ:SCLOStJRE STA'l'EMBNT FOR OWNER. <br />C:I.TY OF ZEPHYREJ:LLS BUJ:LD:ING DEPARTKENT <br /> <br />J:, ~ ~A~/V'-. W~~';+bfl no k<;. <br />agree to the provisions of this instrument. <br /> <br />have read and fulJ.y understand and <br /> <br />The undersi~ed states and affirms that he or she is desirous of constructing, <br />renov.ating, adding to or reroofing his or her ow:n domiciJ.e,. that he or she <br />actuaJ.J.y occupies, or wiJ.J. occupy by said domicile, and same is not for <br />rent, lease or saJ.e. That he or she shaJ.l compJ.y with the folJ.owing conditions,: <br /> <br />J.. That the owner and he or she aJ.one shall act as the builder for all phases of <br />construction. <br />.2. That the owner wiJ.l comply with aJ.J. provisions of the City of Zephyrhills <br />ordinances and codes pertinent to the building. <br />3. That in the event various phases of construction are subcontracted, he will <br />engage onJ.y properly licensed subcontractors and wiJ.l personally supervise <br />such work., <br />4. That in the event the BuiJ.ding J:nspector shall require corrections to be made, <br />the owner will assume fuJ.l responsibiJ.ity to insure they are made, and upon <br />completion will call for a reinspection before proceeding with the 'building. <br />S. That the oWner shall assume full responsibil.ity for the construction and wiJ.l <br />not expect supervision of his work from the City of ZephyrhilJ.s Building <br />Department. <br />6. That prior to final inspection any additional. fees, including reinspection <br />fees, must be paid in full. A written request from this office shall <br />. constitute' an official notice. to pay additional fees. <br />7. That the owner shall comply with alJ. City, State and Federal laws in regard to <br />social security, workman's compensation, lien laws, etc., where applicable. <br />8. That the ow:ner shall comply with aJ.l the safety codes issued by the Florida <br />:Industrial Commission. <br />9. State law requires construction to be done by licensed contractors. You have <br />applied for a permit under an exemption to that law. The exemption allows <br />you, as the owner of your property, to act as your ow:n contractor with certain, <br />restrictions even though you do not have a license. You must provide direct <br />onsite supervision of the construction yourself. You may build or impr~vea <br />one-family or two-family residence or a far.m outbuilding. You may also buiJ.d <br />or improve a commercial building, provided your costs do not exceed $.25,000. <br />The buiJ.ding or residence must be for your own use or occupancy. :It may not <br />be bui1t or, sUbstantially ~roved for sale or lease. :If you sell or lease a <br />building you. have built or substantially improved yourself within 1 year after <br />the construction is complete, the law will presume that you built or <br />substantially ~roved if for saJ.e or lease, which is a violation of this <br />exemption. You may not hire an unlicensed person to act as your contractor or <br />to supervise people working on your building. J:t is your responsibility to <br />make sure that peopJ.e employed by you have licenses required by state law and <br />by county or municipal licensing ordinances. You may not delegate the <br />responsibility for supervising work to a 1icensed contractor who is not <br />1icensed to perform the work being done. Any person working on your building <br />who is not J.icensed must work under your direct supe~ision and must be <br />emp10yed by you, which means that you must deduct F.:I.C.A. and rlthho1di.ng tax <br />and provide workers' compensation for that emp1oyee, a11 as prescribed by 1aw. <br />Your construction must comply with all applicable laws, ordinances, building <br />codes. and zoning r~ians, /.? <br /> <br />OWNER'S S:IGNATUR~'~~AVV1 ~ UJSL~~ DATE c2-/;:I-CJ '7 <br />ADDRESS ' <br />PHONE <br /> <br />WITNESS <br /> <br />PERKJ:T # <br />