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DJ:SCLOSlJRE STATEMENT FOR OWNER CITY OF -ZEPllYREJ:LLS BUJ:LDJ:NG DEPARTMENT ~, . lY\AR-/.I..-.. .~Ol1m0n- . have read and fuJ.J.y understand and agree to the provisions 9f this instrument. The undersi~ed states and affirms that he or she is desirous of constructing, renov.ating, adding to or reroofing his or her own domicile;, that he or she actually occupies, or will occupy bY' said domicile, and same is not for rent, lease or sale. That he or she shall comply with the :folloWing conditions.: 1. That the owner and.he or she alone shall act as the builder -for all phases of,_ construction. 2. That the owner will comply with all proviJ;iions of the City of Zephyrhills ordinances and codes pertinent to -the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work.. 4. That -in the event the Building J:nspector shall require corrections to be made, the owner will assume fuJ.lresponsibili ty to insure they are made , 'and upon completion wili call for a reinspection before proceeding with the building. 5. That the oWner shall assume full respo11Sibi~ity 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 additional 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 shall comply with all the safety codes issued by . the Florida J::c.dustrial Commission. . 9. State law requires construction to be don~ by licensed contractors. You have applied for a pe:cnit under an exemption to that law. The exemption allows you, as the own~ of your property, to act as your own contractor with certain restrictions even though you do not have a license. Yo~ must provide direct onsite supervision of the construction yourself. You may build or improve -a one-fam:i.ly or two-fam:i.ly, residence or a farm outbuilding. You may also 'build or improve a commercial building, provided your costs do not exceed $25,000. The. building .or residence, must be for your own use or occupancy.. J:t may not be built or_ substantially improved' -:Eor sale or lease~ J:f you seJ..l;or' lease' a building yoti. have built or _sUbstantially impr.oved your,se1f,withiIi' 1 year after the construction is cOmplet~, the law will presume - thclt you built or . substantially improved if for sale or lease, which is a. violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building. J:t is your responsibility 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 responsibility 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.:t.C.A. and wj,thholdi.ng tax' and provide workers' compensation for that employee, all as prescribed by iaw. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. ~'S SIGNATUBE ~"^~ - :.~:s~~~'f3~.!) 1'1/: - . "Jf.'. -0 dJ -;if fi--J DATE 4~/;0'7 .r WITNESS PERMJ:lI',#