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. D2SQ,OSURE S'�'a'�'F*�'�•rr .FOR OWNER C=TY OF ZEPHYEtH=I�S BIIII�aTG DEPau�rT�i+ have read and fully usidesstand aad Z, - agr� - to the provisions of �this ins'tr�ess't • The undersigned.states and affirms that he or she is ciesirous of constructing, renovating, adding to or serocfinJ his or her o�n doma-cile, that he or she said domica:le, and same is not for actually occupies, or wi11 occupy b'y �i� .� following conditions: •rent, lease or sa1e. That he or she s2�a1.1 comply 1 Tha -t,he owuer and _ he or she alane sha11 act as the builder fcr a1-1 Phases of construct�.on. of Ze h hills 2. TY3at the owner w111 comply with a.1.1 p=ovisions of �t1ie City P Y=' ordinances and aodes pertinen't to the buildisig • 3, That in the evesit vasious phases of cons'tsuction ase subcontsacted, he will engage only•properly licensed subcontractors and will personally supesvise sueh work. 4. That in the event the Huildiag =nspeator shall r�quire corrections to be made, the �wner will assume fu11 responsibility to irisure •thel' are ��, �d upon completion will ca11 for a reiaspeat�-ca before proceeding with the building. 5. T2zat the owner sha11 assume fu11 respcnsibility fo=' the construction and wi11 not expect_ supesvision of his work from the Ca-tY' of Zephyrhills Buildi.ng Depart�►ent . 6. �hat prior to final inspection any additional fees, including reinspection fees, must be paid in ful1. A written requast from this office sha11 constitute an official notice to pay addit fegs . 7. That the oamer sha11 comply with a11 Ciiy, State asid Federal laws in reg2=d to social security, workman's c��n�ation, lien laws, etc., where applicable. 8. Tizat the ovmer sh�11 comply with al1 the safety codes issued by the Florida Industsial C��ssion. 9. State 1aw re� construction to be done by liceased contractors. You ha.ve applied for a�^^; t urider asi exeapt�-oa to that law. The exemption allows you, as the owrier of yovr property, to act as your own contractor with certai.n restrictions even though you do not have a license. �You must_provide direct onsite supervisiori of the coastraction yourself. You may build or improve a one-family or t�vv-family resideuce or a farm outbuilding. You may also build or improve a commercial building, provided your costs do aot excaed $25,D00. The building or residence must be for your own use or occupaacy. 2t may not be built or subst,antially improved for sale or lease. If you sel:l or lease a building you have built or substantially a.�proved yourself within 1 y�ar after the ❑onstruction is ca�lete, the law will pres�e •that you built or subst�ntially improved•if for sale or lease, which is a violation of this eXemption. You may not hire an ualice.ns�d person to act as your contractor or to supervise people �oorking on your building. It is yovr respozisibility to make sure that people employed by you have liceases res by state law and by county or municipal licensing ordinances. You may aot delegate the responsibility for supervisa.ng wark to a licensed contractor who is not. licensed to per£orm the �aork beisig doae. .AnX p�rson working on yovr bui.ldisig who is not licensad must work uncler your direct supesvision and must be P� ployed by you, which measis that you must deduct F.I.C.A. aad withholding tax and provide workers' c�� *+�ation for that employae, a11 as prescribed by law. Your constrLiction must comply with a11 applicable laws, ordisiances, building codes, and zontag re 'ons. OWNER' S SICATATiJRE � -- - DATE �� ( / ADDRESS PHONE WITbIESS �•R►�T #