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DJ:SCLOStJRE STA'l'EMBNT FOR OWNER CJ:TY OF ZEPBYlUIJ:LLS BUJ:LDJ:NG DEPARTKENT J: , have read and fuJ.ly understand and agree 0 the provisions of this instrument. The un ersigned states and affirms that he or she is desirous of constructing, renova ing, adding to or reroofing his or her own domicile,. that he or she actual y occupies, or will occupy by said domicile, and same is not for rent, ease or sale. That he or she shall comply with the following conditions.: 1. t the owner and he or she alone shall act as the builder for all phases of struction. 2 . t the owner will comply with all provisions of the City of Zephyrhills 'nances and codes pertinent to the building. 3 . t in the event various phases of construction are subcoritracted, he will age only properly licensed subcontractors and will personally supervise h work.. 4. t in the event the Building J:nspector shall require corrections to be made, owner will assume full responsibility to insure they are made, and upon letion will call for a reinspection before proceeding with the building. 5. t the oWner shall assume fuJ.l responsibi~ity for the construction and will expect supervision of his work from the City of Zephyrhills Building artment. 6. t prior to final inspection any additiona~ fees, including reinspection s, must be paid in fuJ.l. A written request from this office shall stitute. an official notice. to pay additional fees. 7. t the owner shall comply with all City, State and Federal laws. in regard to ial security, workman's compensation, lien laws, etc., where applicable. 8. t the owner shall comply with all the safety codes issued by the Florida ustrial Commission. 9. te law requires construction to be done by licensed contractors. You have lied for a permit under an exemption to that law. The exemption allows yo , as the owner of your property, to act as your own contractor with certain. re trictions even though you do not have a license. You must provide direct on ite supervision of the construction yourself. You may build or imprC?vea on -family or two-family residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $25,000. Th building or residence must be for your own use or occupancy. J:t may not be built or sUbstantially improved for sale or lease. J:f you sell or lease a bu lding you have built or substantially improved yourseif within 1 year after th construction is complete, the law will presume .thAt you built or stantially improved if for sale or lease, which is a violation of this tion. You may not hire an. ~icensed person to act as your contractor or supervise people working on your building. J:t is your responsibility to e sure that people employed by you have licenses required by state law and county or municipal licensing ordinances. You may not delegate the ponsibility for supervising work to a licensed contractor who is not eneed to perform the work being done. Any person working on your building is not licensed must work under your direct supervision and must be loyed by you, which means that you must deduct F.I.C.A. and withholding tax provide workers' compensation for that employee, all as prescribed by iaw. construction must comply with all applicable laws, ordinances, building es, and zoning re~lations. ~ 's SIGNATURE ~~ ~~ DATEt'~1 rz,/C:7 r RESS tf'1 Cf If I g-r/A '3( . tY, / NE ~.L;=j~ b~ ~ 0/'0,-// . PERMIT #