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DISCL03IIR8 STATRI�NT F08 Oiirffit CITY OF ��ATLI.S BIIILD� DBPARTMSNT I, Cc have read aad fnlly naderstaad aad agree to pravis'amss of this iastrument. � The undersigned statas and affirme that he or she is desirous of construeting, reaovatiag, adding to or reroofiag his os her ar�n do�t.cile, �h.at he or ahe actualZy occupies, or wi31 occupy by said domicile, and same is not for seat� lease or saI.e_ That he or she shal.l camnpiy �vith the fa3.iowi.a�g conditions: l. That the oovaer and he or she alon.e shall act as the bni.lder far a1], phases of coastxuctioa. 2_ That the owner ovill comply av�.tih all provi.sioas of the City o� Zephyrhills o=d4Tf-�n�es and codes pertiaeat to the bnildiaq. 3_ That ia the eveat vario�s phases of coastsuctioa ase subcantracted, he will engage oaly properly liaeased snbcoatractors aad mill. personall.y supesvise such ovorlt_ 4_ That ia the event �the Building Snspector shall req+ure �orrections to be made, the owaer �rill assume full responsibility to iasnre they, are made, and upon completioxe wil]. ca1Z foz� a reiaspection before proceediag with the buiiding. 5. That the owner sha3.l assnme full responsibility for the construction aad wi7l aot expect supervisian of his work from the City of Zephyrhills Bnildiag DEQwrf-*nnnt. 6. That prioi to final i.nspectioa aay additioaal fees, includiag reinspeation fees, must be pa3d ia fu].1. A orritten request fr� this office shall aoastitute aa official aotice to pay additional fees. 7. That the owaer shall comp].y �vi.th all City, State and 8ederal lav�s ia regard to social secur3.ty, workmaa's compeasation, liea lavrs, etc., where applicable. 8. That the awaer shall comp�.y �►i.th al� the sa.fety cades issued by the Rlarida Iadustrial Commissioa. 9. State law requ:ires constxuction to be done by licensed coatractors. You have applied for a permit under aa exemptioa to that lax. The PXemptiqn al.lovPs you, as the awner of your property, to act as your owa coatsactor ovith certaia restsiatioas evea. though you do aot have a Iiaease. You mnst provide disect onsite superwi.sioa of the constructioa yourself. You may build or improve a one-family or tma-€amily residenae or a farm autbuildiag. Yon may also bui.ld or i.mprave a commerc3al bu%lding, prrnrided your costs do not exceed $25,0�0. The buildiag or resideaae mast be for your owa usa er occupaacy. It �iay aot be built or svbstaafa.ally imLoroved for sale or lease. Zf you sell. or lease a .build3.ag you have built or substaat3a11y impsoned yovrseZf �va.thi�s I. year aftes the constructiaa is complete, the law �.11 presume that you Hui.3t or substantially impraved if for sale or lease, which is a vialation of this exemptioa. Yon may not hire aa unlicensed persoa to act as yonr contractor or ta supervise people morking on your bv:i.Idi.ng. It is your responsibility to make snre that peaple employed by you have liceases r�+,;red by state la�a an.d by caunty or mnaicipal liaensiag ora;*+�++�es. You may aot de2ega�e t.lie respoasibility £ar s�pexva.siag wark to a liceased com.tractor who is aot licensed to perform the �ork beiag doae. Aay pesson vrorkiag oa yout building �rho is aet licensed must �ork uader yowc direat supezvi.sioa aad must be employed I�y you, v�hich meaas that yon must deduat F.I.C.A. aad ari.�hholdiag tax and provi.de �vorkers' coaapeasation far that �nplayee, alI as presaribed by lam. Yovr constzucti�. must co�pl.y 9rith a11 agplicable laa�s, ordinances, bnil.diag codes, and zoaiag lations. X�ss ��` � _ �� /G -�.3--J�- , �� w�sss� ` J p�� #