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. nzsczosvx� s_��'� .FOR owt�R CITY OF ZEPHYRHTT gV22,DaTG DEPARTMENT . have read and fully understand and I, - agree to the provisions of �this instrumesrt • .The undersigned.states and affirms t1�at he or she is desirous of constructing, rer,ovating, adding to or seroofirag his or her own domioile, 'that he cr she actually occupies, or �vi11 occupy by said do�ic'tle, and same is not for •rent, lease or sale. That he or she shall oc wi�th the followiiig conditions: 1 That the owner and_he or she alone sha11 act as the builder for a11 phases of construction . 2. That the own�s wi11 comply with a.11: provisions of �the City of Zephyrhills ordinanees and codes pertiaent to the build.iaq- 3. That in the event various phases of construction are subcontracted, he will EZl gage only�properlY licensed subcontractors and will personally supervise S11CY1 WO=3C . 4. 2'hat in the event the Huildiag Inspector shall rern�'+re corrections to be made, the owner wi11 assume full responsibility to iasure •'thel' ase made, and uPon completion wi11 ca11 for a re�n-�Aa�� fore proceeding with the buildsng. 5. That the owner stiall assume full responsibi.lity for the construction aad wi11 not axpect_ supervision of his work from the Cit1' of Zephyrhills Building Dapastmesit . 6. Ttiat prior to final inspection any additional fees, including reinspection fees , must be paid ixi fu11. A written request from thi.s office shall constitute an official notice to pay additioaal fees• 7_ That the o�vner sha11 comply with a11 City, State asld Federal laws ia regard to social security, warkmaa's compensation, lien laws, etc., where applicable. 8. That the owner sha11 comply with all the safety codes issued by the Florida Industrial Cr+*�++n� ssion. 9. 5tate 1aw requires coxistruction to be done by licensed contsactors. You have applied for a per�t under asi exempti-on to that law. The exe�ption allows you, as the owner of your prcrperty, to act as your own contractor with cert�;T restrictions even though you do not have a license. You must provide direct onsite supervision of the coastruction yovrself. You may build or improve a one-family or tmo-family x�esidence or a fazm outbuilding. You may also build or i�prone a commercial building, provided your costs do :sot exceed $25,D00. The building or residance must be for your owa use or occupancy. 2t ma.y not be built or substantially impr�ved for sale or lease. If you sell or lease a bvilding you have built or substantially improved yourself with,i.n 1 year after the constnictioa is co�plete, the lam will pres�e•that you built or substantially improvad•if for sale or laase, which is a violation ef this exemption. You may not hire asi vnlic�sed pEL�soa to act as your coatsactor or to supervise people morkixig on your building. It is your responsibility to make sure that people employed by you ha.ve licenses rez by state law and by county or municipal liceasing ordiaances. You may not delegate the responsibility for supervising �vork to a licensed contractor who is not. licensed to pesform the worlc beiag dnae. AsiX parsoa working on yovs building who is not licensed must work und�ar yovr direct supervision and must be �ployed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compeasation for that employee, a11 as prescribed by law. Yovr construction must comply v�ith a11 applicable 1aws, ordsslances, building codes, and zoning regulatious. owxER� s szc��txE � n� � r o --�/ ADDRESS • PHONE � WTTNESS �R*'tTT #