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DISCI,OSiJRTz STAT�'N'�' .FOR OWNER C2TY OF ZEPHYEiHTTZ. gLTa,DaTG DEPAR'1T�NT _ , � Q + ~� � � � � have read aad fully undarstaad sud agroe - to the provisions of 'th�.s 1.sls r-r"'"�t. The undersigned.states and affirms that he or she is dQSirous of constructing, renovatsng, adcling to or seroofing his or her owa do�icile, that he or she actually occupias, or xi11 accupy by said da�ici:le, and same is not for •rexit, lease or sal.e. That he or she sha11 c with the fo3.lowing conditions : 1_ That - the owner and he or she alone sha11 act as the buildar for a11 phases of construction. 2, That tha owner vri11 co�ply with a].1: provisions o£ �the City of Zephyrhills ordinances and codes pertinesit to the buildiuq• 3. That in the svsat various pha.ses of constxuction are subcoritracted, he will engaqe oaly�properly licensed subcontractors and will pErsonally supexvise such vrork . 4. That in the event the Building Inspactor shaZl rec� corrections to be made, the owner wi11 assume full responsibility tc insvs'e�thel' are made, and upoa co�pletion will ca11 for a��T«ec�on before proceeding with the buijding• 5. That the owner sha11 ass�e full responsi'k�ilitY far the construction aad �vi11 not expect supervision of his work fro� the City of' Zephyrhills Suilding Depast�ent . 6. �hat prior to final inspection aay add�.tioi�a.l fees, iaclud�-ng rei.aspection fags, must be pai.d ia full. A written request from this office sha11 constitute an o£ficial notice to pay add3.ticaal fees- 7_ That the omnar sha11 comply with all City, S'tate and Federal laws in regasd to social sacurity, workman's compensation, lien laws, etc., where applicable. B. That the owner sha11 comply �it1i aZl the safety codes issued by the Florida Industrial Commission. 9. State law re z�ir es constsuction to be done by licensed contractors. Yoz have applied for a�*�+�; t uader an exemptioa to t�iat law. The eaemption allows you, as the owner of your property, to act as your owa contsactor �aith ep� restrictions even though you do not have a license. You must provide direct onsite supervision o£ the construction yourself. You may build or improve a one-famil.y or t�vo-family residence or a fa� outbuilding. You may also build or improve a commerci.al bvildiag, provid�ed your costs do ziot �caed $25,000. The building or resideace must be for yovr own use or occupancy. 2t may not be built or substantially a.mproved for sale or lease. If you se].l or Iease a bvilding you have built or substaxitially imp=ovad yourself withi.n 1 yaar after the coastruction is ca�pleta, the lax �a.11 pras�e•that you built or substanti.ally improvad if for sale or lease, which is a violation of this exemption. You may not hire an unlicxiris�d persoa to act as your coatractor or to supervise people vvorking on your building. It is yovr responsibility to make sure that people e�ployed by yeu have liceases rern��red by state law and by county or m*TT� cipal licensing o*-�� *+�c�s . You may aot delegate the responsi}�ility for supervising xork to a liceased contractor who is not. licensed to pesform the wark beiag doae_ Aay parson working on yovs buildiag who is not licansad must work uad�er your diract supervision and must b� P� ployad by you, which ma� that you must deduct F_2.C.A. and xit ta�c and provide workers' compeasatioa for ttsat employae, all as prescribed by law. Your construction must comply �vith a11 applicable laars , ord�siances , building codes, and zoning regulations. OWNER' S SIC+NAT[7RE nn�RG! ADDRE55 Q � ._ L PFIONE WTTtJF.RR PEFZM2T #