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I % ' DISCLOSIIRE STATENlENT FOR OWNER CITY OF ZEPHYRHILLS BIIILDING DSPARTM�NT I, ��,ry� �/g!��t?� have read and fully uaderstaad and � agree to the provisioas of this inatrumeat. The undersigned states aad affirms that he or she is desirous of constructing, ' reaovatiag, addiag to or reroofiag his or her owa domicile, that he or she actually occupies, or will occupy by said domicile, and same is aot for rent, lease or sale. That he or she shall comply with the followiag conditions: , 1. That the owaer and he or she aloae shall act as the builder for all phases of construction. 2. That the owaer will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That ia the eveat various phases of construction are subcoatracted, he will � engage oaly properly liceased subcoatractors and will persoaally supervise such work. - 4. That ia the eveat the Buildiag Iaspector shall require correctioas to be made, the owner will assume full respoasibility to iasure they are made, aad upon completion will call for a reinspectioa before proceediag with the buildiag. 5. That the owaer shall assume full respoasibility for the coastruction aad will aot expect supervisioa of his work from the City of Zephyrhilla Building Departmeat. 6. That prior to final inspection aay additioaal fees, iacludiag reiaspection fees, must be paid ia full. A written request from this office shall constitute an official aotice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws ia regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owaer shall comply with all the safety codes issued by the Florida Induatrial Commission. 9. State law requires coastruction to be done by liceased contractors. You have applied for a permit under an exemptioa to that law. The exemption allows you, as the owaer of your property, to act as your owa contractor with certaia restrictions evea though you do aot have a licease. You must provide direct onsite supervision of the constructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuildiag. You may also build or improve a commercial building, provided your coets do aot exceed $75,000. The buildiag or residence must be for your owa use or occupancy. It may aot be built or subatantially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within 1 year after the constructioa is complete, the law will presume that you built or substantially improved if for sale or lease, which is a violatioa of this exemption. You may aot hire an unlicensed persoa to act as your coatractor or to supervise people working on your buildiag. It is your responsibility to make sure that people employed by you have liceases required by state law aad by couaty or muaicipal licensiag ordiaances. You may aot delegate the respoasibility for supervising work to a licensed coatractor who is aot liceased to perform the work beiag done. Any person workiag on your building who is not licenaed must work under your direct supervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholdiag tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all applicable laws, ordinances, buildiag codes, aad zoning regulations. c OWNER'S SIGNATURE DATE ��'°f� �_` �_ ' ADDRESS � PHONE . � Y WITNSSS PSRMIT # I(��S 1 � , � �r-