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, D=SCLO STATS�NT FOR OWNSR � ' , � CITY OF ZSP LL3' HIIII,DING DBPARTI�P7'P _ � _, �� 1. IL l�/�C�� have read and fv.T.ly nnderstaad and agree to t�ie provisions of this ' trument. � The uadersigaed atates aad affirme that he or she is deaizans of acsnstructing, renavatiag, adding to or reroofiag his or her ovra domicile, that he or ahe actually occupies, or will occupy y sa:i.d domicile,- aad same is not fos rent, lease or sal.e. That he or s shall comply av3.th the following conda.tions: - I. That the ownes and he or she one shall act as the bnilder for a17. phases of coastruction.. � '' 2. Tl�a,t th.e awaer mill comply �vi. all provisions of the City of Zephyrhills ordiaaaces aad'codes pertiaeat to th� bnildiag. 3. That ia the eveat variovts phas � of constsuction are subcoatsacted, he miil eagage only psdperly licensed nbcoatractors aad ov3.11 parsonally supervise such ovork. 4. That i.a the eveat the Buildias Inspector shall require aonecticas to be made, the owaer v�ra.11 assume fu11 res onsibility to insnre they, are made, and upon completioa w:ill call fox� a re ection before proceed:i.ag with the buildj.�g. 5. That the owner sha1Z assume 1 responsibility for the constrncta.on �and wi].I aot expect supervision of his rk from the City of �ephyrhills Bnildiag Departmeat_ , 6. That prior to fistal inspectio aay additioaal fees, inclnding reinspection �eea, must be pa3d ia fu7.1. vrrittea reqaest from this otfice sha17. conBtitute an official notice o pay additional fees. 7. That the owaer shall comp].y wi all City,� State and Federal lav�s ia regard ta social security, vrcrkm�a.'s c easatioa, lien lavvs, etc., where applicabl.e. 8. That the ovQaer sha3.1 comp�.y all. the sa£ety codes, iasued by the Florida Indnstrial Commission. 9. 3tate law requires canstructi ta be done by liceased coatractors. You ha�e ' applied for a perm:it under an exemption to t;hat law. The exemptioa allowa you, as the owner of yaur pr ty; to act as yonr own contsactor vaith certain restsictions even though you. aot have a Iicense. You must pravide direct oasite supervision of the co tion yourself. You may build or i.mprove a one-family or two-family resi c.�ce or a farm outbuilding. Yau may alsc build or i.mprave a cammercial build' q, prrnrided your costs do aot exceed $25,0�0. , The buildiag or reaideace mns be Eor your owa use or occupaacy. Tt may aot be built or substantially imp ved for sale or lease. z£ you se11 or lease a .bua.lding you have built or s staatially improved .yourself withia l. year after the coastruction is coiaplete, the I.aov ovill pres�e that you built or snbstaatially improved if £or eale or lease, which is a violatioa of thi.s exemgti.on._ You may aot hire lmliceased person to act as yons contractor or to supervise people vPOrking your building. It is your respoasi.bility to make sore that people employ by you have licenses s�t77red by state law aad � by aowaty or muaicipal ].icens' g Or�'�*!a*��=@8. You may not delegate the responsibility for supexvisin work to a licensed con.tractor who is aot licensed to perform the mork eing done. � Aay pexsaa working on you� buildiag who is net licensed must work under yonr direct supesvisioa aad muat be employed by you, which meaas t yon must dednct F.I.C_A_ and withholdiag tax �I and provi.de warkers' co�peasa "on far that employee, a11 as prescsibed by la�_ � Yaur constxuction must comply �rith aZl applicable Iaws, ordiaances, bn.i.Id:i.ag codes, and zani.ag regal.ati.ona . OW1r3S8'S SIGNATIIR$ � � D8T$ �-�-�� ADDRBSS c� 7�[�Dl- Q /YZlJ� � �/ YHOl� . 7 J- a 7 WITI�TSSS• PSItMIT #