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' DISCLQSURE ST,3�.'E;%i'�NT .FOR t3W2dER � CZ'Z^.�' OF ZEPH'.i'RFi27.�LS �L7II.DZN6�DEPARZ'MENfi _, ` have read and fuS1y understand and agsee •ta the provisions o� �th7.s instrutn�t. .The undersigned .statas and affirms tha� he or she is desirous of cons�ructing, reziova�.i.ng, adcia.ng to or �eroofing hi.s or her ovm demicile, �-..hat h� or she � actuall,y occupies, or wi7.2 occupy by � said domic�:�e, and same is not �ar •rent, lease or sale. That he or sh+e sh��ll co�ply with t3ze following condi-t.a.ons: , 1. That the awzxer aad,he or she a7.one sha].�. act as -the bvilder for all phases of constructiozi. _ Z. That the owner wi'll comply with a17: pravisions a� �the City of Zephyrhil�s ordinances and cbdes pertineat to the building. ' 3. fihat in the a�vent vasious phases of construction are subaontra�tad, he wi�.l engage anly •prop�rly licerised subcantractors and will ppssonal�y superv�se� such wask. 4. That in the even� the Building `Inspector shall se�+�i�re co�crecti.ons to be made, the owrser i+rill assume full responsibility -to inaure �they are made, and upon ca�cpletion will. aaI'Z �or a raixispection before pxaceeding w3th the buil.ding. 5. That the owner sha11 ass�e fu11 responsibili�y ior the� canstruction aud wia.1 not a�+�ct_ supervisiari of his wark from the Gity cf Zephyxhil�.s Btzz.lding � Depar�esit. . • � 6. Z'2iat pr3.ar to final inspection any additional fe+�s, including reiaspec�i.on fees, must be pai.d izi �ful7.. A .written s�quest f�om �his office shall constitute a�n of�icial notice to pay additi.atial �'aes.. . � 7. �ha.t t�ie own+er sha1Z comp2y with a21 Cit.y, Sta�te and Feder-�1 laws in regard ta soc.i.al �e�ity, worksaan's comg�ensatioa, lien laws, etc. , where applicable. 8. That ttxe awn�r sh�11 campZy wi.th aZl the safe.ty codes issued }5y the Fli�rid.a Industsa.al Commission. 9. State law re�,;res caxrstruatiari to be dane by licenseci contractors, You have appl.ieci for a pe�mit under an exe�ptian tto fihat law. fihe exea►ption a3,l.aws you, as the owrier of your property, to act as yaur owa cara.tractor with cer#�,ia rastsictions even thaugh you do no'� have a I.iaens�. You must .prov5.de diract � onsite supervision of the construction yovrself. You may build ox impscrve a ane--fami.ly o,x twa-family sasideaae or a far� out}auilding. 1au may also build ' or improve a commescial bttildi.ng, provi.d�d your aosts c3o zi,ot cxc�ed $25,000. , The building or residence•must be �or yaur awn use or occupancy. .It may nat be bui1� or substaati.al3y i�pro�sred for sale ar lease. If you sel'1 or 1.ease a bui.l.ding you have buil.t os substant3.a11y improved yourself within 1 year after the censtruction is co�plete, the laar w�.11 psesume•�hat ycu built ot su�,stan�.ially impsoveci s.f far sal� ar lease, whi.ch is a vi.olation of �.i.s eXemption. You may zrat hire a,ri unlicensed persan to act as your cantraator or ' ta sup�zvise people working on yaus bui3dinc,�. It is yous responsi:bili.ty to make swce that people emplayed by yau have ].ic�ses r��7�red }ay s�a.te 1aw and by e.oun�y ar muz�i.cipal lic�sing ordinasiaes. Yau may no� delegate the responsibili.ty foz superv-ising work to a Ii.censed corxtractar who i.s not. 1ic�nsc.ci to pexf'o� the wc,r7c being dnnm. Arsy pesson work�.ng o1z ydvr buildizig who is zxot �.ic�uus�d must wor3c uncie�s yac� dis$ct supezvisi.ozi asxd must be P�ployed. by you, which meaus that you io.ust deduct F.S.C.A.. and wi�hholcling }=Y and provide workers' comp�,usatian i"or tt�iat �aployee, a11 as presc=ibed b� 1aw. Yous coxzstsuctiorl must compZy with a1I applx.cabl.e laws, a�diriazzces, building codes, aad zaning regulata,ons. r OWt�'ER'S SIGNATLTFiE DA2'E �.p �� ^" c�DI,� ��i�ss / . P�IO2wTE p.- W�TNESS PERMIT #