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. • D2SCLOSVRE S't'a'�•*�•NT .FOR OWI�R CZTY OF ZEPHYRHII�I+S BLTILDSNG DEPARTI�NT _� _� �� y have read and fully understand arld agree •to the psovi ions of �this instrume�t. The undersigned states and affirms that he or she is desirous of constructing, r�ovating, adding to or seroofing his or her own 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 sha11 comply with the followiing conditions: 1. That the owner and.he or she alone sha11 act as �-he builder for a11 phases of constrLiction. - 2. That the owner wi11 comply with a11 provisions of �the City of Zephyrhills ordinances and codes perti.nent to the building. 3. That in the event various phases of construction are subcontracted, he wi11 engage only properly licerised subcontractors and will pPSSOnally supervise such v+ork. 4. That in the event the Building Znspector shall rec�,;re corrections to be made, the ownes will assume full responsiUility to insure •they are made, and upon cc�pletion will call for a reinspectioa be£ore proceeding with tYie building. 5. That the owner sha11 assume fu11 responsibility for the constsuction aad wi11 not axpect_ supervision of his work from the City of Zephyrhills Building Depart�ent. 6. That prior to final inspection any addit�.ona1 fees, including reinspection fees, must be paid ia fu11. A writteri request from t.�iis office shall constitute an official notice rto pay additional fees.. 7. That the owner sha11 comply with a11 City, State and Federal laws in regard to social security, warkmaa's compensation, lien laws, etc. , where applicable. B. That the ownps sha11 comply with al1 the safety codes issued by the Floricia Industrial Commission. 9. State 1aw rernii res constrLiction to be done by 1ice�sed contractors. You have applied for a �r+�+;t undes an ex�ption to that law. The exemption allows you, as the owsser of your property, to act as your own contsactor with certain restrictions even though you do not have a license. You must prvvide direct onsite supervision o�' the construction yovrself. You may build or improve a oae-family or two-family residence or a farm outbuilding. You may also build or improve a commercial huilding, provided yovs costs do not �cceed $25,000. The building or resideace must be for your own use or oc.r�..ixpancy. It may not be built or substantially i�prov�d for sale or lease. If you se1:l or lease a building you bave built or substantially i�proved yourself within 1 year aftPs tbe constniction is complete, the lap wi11 pres�e �that you built or subst�sztially improved •if for sale or lease, which is a violation of this exemption. You may not hire an vnlicensad person to act as your contractor or to supervise people workiag on your huilding. It is yovr responsibility to make sure that people e.�ployed by you have licenses reqt,;red by state law and by county or municipal licensing ordinaaces. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to pesform the work being dnaa. Ariy person working on yous building who is not licansed must work undnr your direct supervisioa and must be Employed by you, which meaas that you must deduct F.I.C.A. axid withholding tax and provide workers' compEnsation for that employee, all as prescribed by law. Your construction must comply with a11 applicable laws, ordinances, building codes, and zoning regul tioris. �W2�R'S S2GI�iF�fiL7RE DATE ��I ZG/1 � ADDRESS S 7�� 7 PHONE �s'I� (o„1� �jp/ W2TNESS PERM2T #