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I ' I I � � • � nzscz.os STAfTEMENT .FOR owr�R C2TY OF ZEP TS:L$ 'ELTII.D2NG DEPARTI��NT _, � SS _ �� have read and fully understand and agrae •to the provisions of �this in trumeiit. .The uridessigned .states and affirms that �e or she is desirous of �onstructing, renovating, adding to or reroofing his or hes own domicile, that he or she actually occupies, or wi11 occupy � said domiaile, �and same is not for ' •rent, lease or sa1e. That he or s e sha11 comply with the following conditions: 1. R�hat the owner aad_he or she one sha11 act as the buildes for al1 phases of const-suction. - 2. That the owner will comply wi a11• ,p�rovisions of �the City of Zephyrhills ordinances and codes estineat to the building. � P 3. That in the event various phas s of construction are subcontracted, he will eSS�age only •propesly licensed ubconttactors and will pessonal�y supervise such work. 4. Z`hat in the event the BLUlding Znspector shall rec�,;re corrections to be made, the ownes will assume fu11 re onsibility to insure •they are made, and upon completion will ca11 for a re' ection before proceeding with the building. 5. That the owner sha11 asst�e f 1 responsibility for the coastsuotian aad wi11 not expect_ supe.rvision of his ork from the City .of Zephyrhills Building II Department. -� 6. That prior to final inspection aay additional fees, including reinspection fees, must be paid in full. A written request from t�us office sha11 � constitute an official notice o pay additional fees.. 7. 'Z`h�-st the ownes sha11 comply wi a11 City, State and Federal laws in reg-ard to social seauri�y, worl�►an's c esisation, lien laws, etc. , where applicable. ' B. That the ownes shall comply wi all the safe.ty codes issued by the Florida Industsial Commission. • 9. State 1aw rem�;ras constructio to b done by licensed contractors. You have applied for a permit undps an e�pti.oa to that law. The exemption allows you, as the ownes of your pro ty, to act as your own contractor with cert=;*+ restrictions even t�iough you d not have a license. You must ,provide direct onsite supervision of the cons ction yourself. You may build or improve a one-family or two-fama.ly resid �ce or a farm outbuilding. You may also build - or improve a commescial bvil ' g, provided your costs do not exoeed $25,000. I , Z'he building or reside�ce•must be for yovr own use or occupancy. It may not be built or substasitially i�pr ved for sale or lease. If you se.I:l or lease a bvildiag you have bvilt or sub taat3a11y i.�proved yovrself within 1 year aftES the construction is co�plete, e la�i wi.11 pres�e •that you _built or substaatially improved •if for a1e or lease, which is a violation of this P�Cemption. You may not hise unlic�sed person to act a"s your contsactor or to supervise people working on your building. 2t is yaur responsibility to make sure that people F�played by you have licenses rei,;red by state law and by county or municipal liceris' g ordinances. You may not delegate the responsibility f'or supervising work to a licensed contractor who is not. 1ic�sed to perform the worh b ' g dcne. Ariy person working on yovr building who is not licensed must work cler �our direct supervision and must be P�ployed by you, which meaus t you must deduct F.I.C.A. and frithhold.i.ng tax and provide workers' compeasa on for that employee, all as prescribed by law. Your construction must comply ith a11 applicable laFrs, ordisiances, building codes, and zoning regulations. OW1�R'S SIQ�TURE � Q ' DATE �`�-3C� --r�l ADDRESS (�S� cKr.�cor I 2 ' S � � PHONE � I - ' W2TNE55 PERt�T #