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• D25CL�SIIRE S'r'a'r'F'*�'*rr .FOR OWNER CITY OF ZEPHYRHI2� SQ��G DEPARTMENT . have read and fully urid?sstand and _, - aqree - to the provisions of �this instsumerrt - .The undersigned.states and affirms that he or she is desirous of constructing, reszovating, adding to or �eroofing his or her o�vn domicile, that he or she said domicile, and same is not for actually occupias, or will occupy bY y ,�y.� .� following coaditions: •resst, lease or sa1e. That he or she shall comply �.. That the ownar aad_he or she alone sha11 act as the builder for a11 phases of constnaction. 2. Tk,at the owner wi11 comply with al'1 provisions of 'the City of Zephyrhills ordinanees and codes pertiaent to the bvildiaq• 3, That in the event vasious phases of construct are sul�contracted, he will engage orily�properly licensed subcontractors and will pErsonal.ly supervise such work. q, That in the event the Building Inspector shall rec� corrections to be made, the owner wi11 assvme full respoasibila.tY to ias�e '�eY az'e made, and upon completion will ca11 for a re�T1-�cti-on before proceed.itig wi'th the build3ng. 5. That the owner sha11 assume fu11 responsibility fo=' the construction aad �ci11 not expect_supervisioa of his work fro� the CitY of Zephyrhills Bvilding Department. 6. That prior to final inspection axiy adrlitional fees, including reinspection fees, must be paid in full. A written requast from this office sha11 constitute an official notice to pay additional fees• . 7. That the owner sha11 comply with a11 Ciiy, State and Eederal laws iu regard to social security, workman's compeasation, lien laws, etc., where applicable. B. That the owsser sha11 comply with a11 the safety codes issued by the Florida Industsial Comm.ission. 9. State 1aw re�+ constructioa to be done by licensed contractors. You have applied f or a perm=t under ari exemptian to that law . The exemption allows you, as the owner of your property, to act as your own contractor with certaiIS restrictions even though you do not have a license. You must,provide direct onsite supervisioa of the construction yovrself. You may bvild or improve a one-family or twe-f'amily residence or a f�rm outbuildiag. You may also build or improve a commercial building, provided your costs do aot excaed $25,000. The buildi.ng or residence must be for your owri use or ocCllpancy. 2t may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially i�proved yourself within 1 yeas after the construction is complete, the 1aw wi.11 pres�e that yon built or substantially improved•if for sale or laase, which is a violation of this EX emption. You may not hire an unlicerssed person to act as yovs contsactor or to supervise people workixig on your building. It is your responsibility to make sure that people employed by you have licenses re? by state law and by county or municipal liceasing ordinances. You may aot delegate the responsi'bility for supexvising �vork to a licex�.sed contractor who is not licensed to perform the work being dnsse. Aay Parson working on your buildiag who is not licsnsed must work under yovs direct superv'ision asad must be �ployed by you, �vhich meaas that you must deduct F.I.C.A. and witht�iolding tax and provide workess' compensatiori for that employae, a11 as prescribed by law. Your constrsxetion�mrtst comply v�ith al1 applicable laws , ordinances , building codes , and zonin regu3atia�ns: � ' r .owr�Ft� s sz� �cA <�� n� o� �- 1 �Dx�ss 3� r,( �`a � � i4 ►� - 2 (-� �� c� r= PHONE . C i'1' 1 .� -- � � � - �f S �� { W2TNESS PERL�T #