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• DISCZOSL7RE S'�'A'�'�'*�=NT .FOR OWNER C=TY OF ZEPHYRFiII�+S BUII+D2NG DEPARTD�NT _ • have read and fully understand and , - agrae •to the provisions of �this instrumerit• .The undersigned sta.tes and affirms that he or she is desirous of constructing, renovating, adding to or seroofing his or her o�vn domicile, •that he or she actually occupies, or wi11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she shall comply with the fol.lowing conditions: 1. Tha.t the owsier and_he or she alone sha11 act as the builder for a11 phasas of constsnction. 2. That the oamer ovill comply with a11 provisions of �the City of Zephyrhills ordinances and codes perti.neat to the building. 3. That in t�e event various phases of construction are subcontracted, he will angage only •properly licensed subcontractors and will persoz�ally supervise such work. 4. That in the event t�ie Huilding Inspector sha11 reqLS7.re corrections to be made, the owner vPi11 assume full responsibility to insure •tt�ey are made, aad upon co�pletion wi11 call for a reinspection be£ore proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the constr�iction and v,ri11 aot axpect_ supervision of his �vork from the City af Zephyrhills Building Depart�ent. 6. That prior to final iaspection aay adrlitiorial fees, including reiaspection faes, must be paid ia full. A writtea request from this office sha11 constitute an official notice rto pa.y additional fees. 7. That the owner sha11 comply with a11 City, State and Eederal laws in regard to social security, worl�an's c��*+�ation, liea laws, etc. , where applicable. 8. That the owner sha11 comply witli all the safety codes issued by the Floricia Industrial C�+�+�ssioa. 9. State law re��ires coastxzaction to be done by licensed contractors. You have applied for a �rm;t under an exemption to t�at law. The exemption allows you, as the owner of your propErty, to act as your owa contractor Frith ce*�+-=�*+ restrictions even though you do not have a licease. You must provide direct onsite supervision o� the construction yourself'. You may bvild or improve a oae-family or two-f'amily resideace or a farm outbuilding. You may also build ar improve a commercial building, provided your costs do not exceed $25,000. The building or resideace must be for your own use or occupaacy. It may not be built or substaatially improved £or sale or lease. If you sell or lease a b�ilding you have built or suUst-antially i�roved yourself wit�.in 1 year aftE=' the construction is camplete, the law will pres�e •t�at you built or substantially i.mproved •if for sale or lease, which is a violation of this ex�ption. You may not hire aa unliceas�d pErson to act as your contractor or to supervise people working on your building. 2t is your responsibility to make sure that people e�ployed by you have licenses rez,;red by state law and by county os municipal licensi.ng ord�siances. You may not delegate the responsibility for supervising wor3c to a licensed contractor who is not. licensed to perform the work be.ing doaa. Any person working oa your building who is not licensed must work vader your direct supervisioa and must be P�ployed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, a11 as prescribed by law. Your construction must comply with a11 applicable laws, ord�siances, building codes, and zoning regLLlations. OWNER'S SIQiATLTRE �/S.Go ��Q��E'0�� DATE a - ��aQ/ o� ADDRESSe',��S( 7-A'IP L �� / PHONE S� /.'� rI O� R S/ // W2TNESS �'•R►�TT #