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'" . � D25CLOSLTRE S'►'a'r�:�"NT .FOR OW�R C2TY OF ZEPHYIiHIT�+B SV=I�Dn'TG DEPARTI��NT • have read asd fully understand and =r - agree �to the provisions of 't'.h�-s instrument• .The undersigned sta.tes and affirms that he or she is desirous of constructing, raxzovat.ing, adding to or �eroofing his or her own do�-cile, �that he or she actually occupies, or wi11 occupy by said domicile, and same is not for •rent, lease or sa1e. That he or she shall comply with the followiing conditions: 1, That the owner and_he os she alone sha11 act as �-he buil.der for al1 phases of consts�.iction. 2, T2�,at the o�vaer will co�ply with a11 provisions of �the City of Zephyrhil'ls ordinances and codes pertinent to the build.issg• 3, That in the aveszt various phases of coastruction are subcontracted, he wi11 erigage orily properly licensed subcontractors and will personal�.y supervise such work. q, fihat in the everit the Building =nspector shall rec�T'+Te correctz.oas to be made, the owner vrill assume full responsibility to insure •they are made, and upon completion wi11 ca11 for a reinspeation be£ore proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the coast-suctian and vri11 aot axpect_ supervision of his mork from the City o£ Zephyrhills Building Depar��t. 6. That prior to final inspection aay additiana.l fees, including reinspection faes, must be paid iri fu11. A written request from tt�.s office sha11 constitute an official aotice rto pay additional faes• 7. That the ownar shall comply vrith aZ1 City, State and Eederal laws in regard to social security, warkmasi's compesisat�on, lien laws, etc. , where applicable. 8. That the ovmer shall comply with a11 the safety codes issued by the Florida Industrial Commissioa. 9. State 1aw rec�,;*-es construction to be done by licensed contractors. You have applied for a permit under an exe�pticn to that law. The exEmption allows you, as the owner of your property, to act as your owa contractor with certain restrictions even though you do not have a licease. You must provide direct onsite supe=vision of the construction yovrsplf. You may bvild or improve a one-family or two-fam.ily residence or a farm outbuilding. You may also build ar improve a cammercial building, provided your costs do not exceed $25,000. The building or resideace must be for yovs own use or occupancy. St may not be built or substantially i�proved for sale or lease. If you se]:l or lease a buildi.ng you have built or substantially i�proved yourself within 1 year after the constructi.on is complete, the law will presume �that you built or substasiti.ally improved �if for sale or lease, which is a violation of this exempti.on. You may not hire an ualiaensed person to act as your coatractor or to superPise people working on your building. 2t is your responsibility to make sure that people employed by you have licenses re?,;red by state law and by county or municipal liceasing ordinassces. You may not delegate the responsibility f�r supervising work to a licensed contractor who is not. licensed to pesform the �vork being doaa- AuY P�rson working on your buildiag who is aot licensed must wark undes yovr direct supervision and must be P�Ployed by yau, which meaas that you must deduct E.I.C.A. and wit�holda.ng tax and provide workers' compe�nsation for that employee, all as prescra.bed by law. Your construction must comply with a11 applicable 1aws, ordinances, building codes, and zoning regu.lations. �x� s s=cr�� E"�� - o.-rr-.�. n� 3-) S-- 1�Z ADDRESS PHONE W2TNE5S �'•R*�TT #