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DISCLOSIIRE STATEI�SNT FOR OWIdSR CITY OF ZEPHYRIiILLS BIIILDING DSPARTN�N'P 8 / .� 2, / /��(/��/� �� i�j�/"� have read and fully uaderstand aad agree to the provisioas of this instrument. The undersigned states and affirms that he or she ie desirous of constructiag, reaovating, addiag to or reroofiag his or her own domicile, that he or �he actually occupies, ox��:--eee�gg-� said domicile, aad same is not for , rent, lease or sale. That he or she shall comply with the following conditions: 1. That the owaer and he or she aloae shall act as the builder for all phasea of conatruction. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordinances aad codes pertinent to the buildiag. 3. That ia the event various phases of coastruction are subcontracted, he will � engage only properly licensed subcoatractors and will persoaally supervise such work. 4. That ia the event the Buildiag Inspector shall require corrections to be made, the owaer will assume full respoasibility to iasure they are made, aad upon completion will call for a reinspection before proceediag with the building. 5. That the oaiaer shall assume full respoasibility for the constructioa and will aot expect supervision of his work from the City of Zephyrhills Buildiag Departmeat. 6. That prior to fiaal inspectioa any additional fees, iacluding reinspection , fees, must be paid in full. A writtea request from this office shall constitute an official aotice to pay additional fees. 7o That the ownes shall comply with all City, State aad Federal laws in 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 Industrial Commissioa. 9. State law requires conetructioa to be doae by liceased contractors. You have applied for a permit under aa exemption to that law. The exemptioa allows you, as the owaer of your property, to act as your owa coatractor with certaia restrictions evem though you do aot have a license. You must provide direct oasite supervision of the coastruction yourself. You may build or improve a one-family or two-family resideace or a farm outbuildiag. You may also build or improve a commercial buildiag, provided your coats do aot exceed $75,000. The buildiag or residence must be for your own use or occupaacy. It may aot be built or substaatially improved for sale or lease. If you sell or lease a buildiag you have built or substaatially improved yourself within 1 year after the coaetruction is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violatioa of this exemption. You may not hire an unlicensed persoa to act as your contractor or to supervise people workiag oa your buildiag. It is your respoasibility to make sure that people employed by you have liceases required by state law aad by couaty or municipal licenaing ordiaances. You may not delegate the respoasibility for supervising work to a liceased coatractor who is aot licensed to perform the work being done. Any person workiag on your buildiag who is aot liceaeed must work under your direct supervisioa aad muat 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 muet comply with all applicable laws, ordinances, buildiag codea, and zoning regulations. � OWNER'S SIGNATURE A DATE � ,. / �. � ADDRBSS ✓ PHONS y"j � . ' ' ��..r WITN�.'SS !�-rv.� � � PSRMIT #