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<br />, DJ:SCLOStJRE S:r~ FOR OWIJER,'. <br />c::t'1'Y OF Z~S Btl'J:LII:r:NG DEPAXT.MBNT <br /> <br />:t, .13.. i '" " -s. (J r Q l' \'1 e 11 :ba.... read. ~. fuJ.1y _stand and <br />'agree to the .prOV':is:ions. of 'tms :i:os~' <br /> <br />..-he und""d_" states and af~i>mS that 'be or she.. is dasiraWO o~ c"""tree~, <br />r~ting, a~ to or rsroo~ing his or her ~. domi~1e., that be cr sbe <br />ac=a.:uy oc",,;d,"", or..;.11 occupy by .."''', domi~1e. .""",...... is, ",;,t for <br />",ant. .1e"".. or .aJ.e. . "".,t he or she shaJ.J. _1y _th the ~o11ow=g CODdi"'-ODS" <br /> <br />1. "",.,t the """"" ;mil he or sheo1ODe sI>a11 aCt .... -the bullilsr ~or 011 phaseS of.. <br /> <br />ccmstrUct:i.Cl:I.. <br />2. =t the """"" ";'11 comp1Y ..;.th 011 p=",-siODS of the City of Z_h1J.1. <br />ord:i.nances cm.d codes' pe:rtine:At to the :bU:iJ.di:ng. ' <br />3 . "".,t.....the...-t """ions phases o~ c"""""""tion are .""contraCted.. he will <br />_ge onJ,y properl.Y 1ic......e" """,con_tor. """ ..;.ll p"".=y. s"."'''''''.. <br />such work.. ' ' <br />. . =t.... the ...._t the Bui1ding :<napeetor shaJ.J. requi>:e oor.rectionS to he made. <br />the owner win aSs..- fnJ.]; reSPonSihiUty to ",""",e 'the,y are ......., .""" upon <br />comp1etioO. .dll c.u ~or a reiDSPection hefore proceeding .dth the l>Ui1ding, <br />5. =t the oWer shaJ.J. a."'- fuJ.1 i-asp"""ihiUty ~or.the ."""treetion and wi11 <br />not _ct ""parvision o~ hi. ;.ork from the.City o~ z_hi11. Bui1ding . <br />Depa.:rtm~t - <br />6 , =t prior to fi=:! ;",spection any ad<litiODBJ. ~_.; i=1uolli>g roU,nspection <br />fees, must be pa.:i.d i.XL fuJ.J.. A w:i::':itt~ request frcm th:is off:ice sha.J.J. <br />,ccmst:itute' an off:ic:i~ not:ice.to pay add:it:ianaJ. fees- <br />7. =t the owner shaJ,1 comp1y with .:u City. State an" Feder"" 1aws. .... regard to <br />sod"" .e"",dty, war"""'" s cam....osat;.on. 1ian 1aWS. etc.. "here sppUcahle, <br />. . =t the """"" .-11 comp1y ..;. th .:u the .afety co...... i.sued by the F10tida <br />Industr:iaJ. ccmm:iss:iCl:l.. <br />g . State J.aw requ.:ires ccmstructi.O%1 '1::.0 be d.o:tLe,:by J.:ic~sed ccm.tractors - You have <br />appJ.:ied for' a pe:cu:i. tu:c.d.e:r an ex~t:icm. to that J.aw - '!'he exempt:icm. aJ.J.OWS <br />yOU. .... the ~er of ,..,- proparty. to act as your own contractor with cert...... <br />restr:ict:iO%1S ev~ tho'11gh you do not ha'V'B a J.:icen.se. You must provi.de d.:irect <br />cms:ite superv:iS:iOIl of the ccmstr\1Ct:iOIl yourseJ.f. You may bu:i.J.d or :impr~e.a <br />cm.e-fam:i.J.y or two-fam:iJ.y res:id~ce or a faxm out::bu:i.J.di:ng- YOU may aJ.so bu:i.J.d <br />or ;"prave a cammarciaJ. h<d1dins. proTidedyour costode not ~eed $25.000. <br />The :bu:i.J.d:ing _or res:id~ce must be for your OWXL US,e or occupancy. It may not <br />be bu:i.J.t or, sUbstant:i.aJ.J.y :improved ':fer saJ.e' er J.ease~ If' you seJ.J. or J.ease' a <br />bu:i.J.d:iDg you, havebu:LJ. te'r . ,~U:bstant:iaJ.J.Y :imp~C'V'ed you:i:,seif W:L~' J. year after <br />the ccms~ct:iO%1 :is ccmpJ.ete, theJ.aw ~J.J. presUme'th&~ yeu bu:iJ.t or <br />s-ubstant:iaJ.J.y :improved :if for saJ.eer J.ease, w:b.:i.ch :is a v:ioJ.at:iO%l. of th:is <br />exempt:ion- You may :D.ot:b.:i.re a:c..' uuJ.:icensed persOIl to act as your contractor or <br />to ."parviss p~op1e warlW>!! on your bull dins . :tt is your rsspODSihiU ty to <br />make sure that pecpJ.e empJ.oyed :by you have J.:icen.ses requi.red :by state l.aw and <br />by CQUDty or mun:i.c:ipaJ. J.:icEm8:i.Dg ord;i.Da:D.ces. You may net, deJ.egate the <br />respons~~J.:ity for sUP~S~g work to a J.:icensed contractor who :is not <br />~:ic~ed to ~er:fo:cn the Work be;i.:D.g doD& _ AxI:y person work::i:D.sr CD your bu.:i~di.nsr <br />who :loS :c.ot ~:loce:c.sed. mc.st w:,:'rk u:c.de:r yc:ra:r ~rect su;perv:i-s:i.o:c. a:c.d :an:u;t be <br />em;p~cyed.:byy'OU, wh:ic:h meilDS' that you must deduct p'.J:.C.A. aDd w:i.tl:1ho~d.:i.:c.g tax' <br />and prOV:l.de wo:kers' ccmpeDS,at:iCl:l. for that em;p~oyee, aJ.~ as presc:r~ed by iaw. . <br />your cODStruCt>.on mnat """",:Ly ~cah1e 1..... ord' . "ncsS , "",,'ding <br />oodes. =d:_ ~guJ.ati"""~~. . <br /> <br />oWNER'S SIGNA'l"tmJ!: ~~ _.-:"" DATE '-/ -/ / - r;f7 .r <br />ADD:RESS 0 r#' - <br />PBONE 2 <br /> <br /> <br />w:rTNESS <br /> <br />Pxexr.r-# <br />