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: DISCLOSIIRE STATEN�NT FOR OWNER CITY OF ZEPHYRI3ILLS BIIILDING D$PARTN�NT I, �'L�J � • �� have read and fully uaderstand aad agree to the provisions of this instrument. The uadersigaed states aad affirms that he or she is desirous of conatructiag, renovating, addiag to or reroofiag his or her owa domicile, that he or �he actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the followiag conditioas: 1. That the owner and he or she aloae shall act as the builder for all phasea of construction. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordiaaaces aad codes pertinent to the buildiag. � 3. That ia the event various phasea of coastructioa are subcontracted, he will engage only properly liceased subcoatractors and will persoaally supervise such work. 4. That ia the event the Building Iaspector shall require corrections to be made, the owaer will assume full respoasibility to iasure they are made, aad upoa , " completioa will call for a reinspectioa before proceeding with the building. 5. That the owaer shall assume full respoasibility for the construction and will aot expect supervision of hie work from the City of Zephyrhills Suildiag Departmeat. 6. That prior to fiaal inspection aay additional fees, includiag reiaspection fees, must be paid in full. A writtea request from thia office shall constitute aa official aotice to pay additioaal 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 owner shall comply with all the safety codes issued by the Florida Induetrial Commission. 9. State law requires constructioa to be doae by licensed contractors. You have applied for a permit uader aa exemption to that law. The exemption allows you, as the owner of your property, to act as your own coatractor with certaia restrictions evem though you do aot have a licenae. You must provide direct onsite superviaioa of the coastruction yourself. You may build or improve a oae-family or two-family resideace or a farm outbuildiag. You may also build or improve a commercial buildiag, provided your coets do aot exceed $75,000. The buildiag or residence must be for your owa use or occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substaatially improved yourself withia 1 year after the construction is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violation of this exemption. You may aot hire aa unliceased person to act as your contractor or to supervise people workiag on your building. It is your responsibility to make sure that people employed by you have licenses required by state law aad by county or municipal licensiag ordiaaaces. You may aot delegate the responsibility for supervising work to a licensed coatractor who is aot licensed to perform the work beiag doae. Aay pereon working on your buildiag who is aot licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. aad withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all applicable laws, ordinaaces, building codes, aad zoniag regulations. OW1dER'S SIGNATURE D� DATE S '�� V��/� �nnx�ss 3�' PHONS � `-"� WITNF.SS PBRMIT #