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i , DISGLOSDRS STATS�N'r FOR OWNSR CITY OF ZSPBYRHILLS BIIII,DING DBPARTI�NT / s � T, �_ •2_° l�Ll �✓�vt.Cb � have read aad fully understaad aad agree to the provisioas of this iastrument_ - The uadersigned states aad affi.rme that he or she is desirous of constructing, I renovatiag, addirig to or reroofiag his or her owa domicile, that he or she actually occupies, or will occupy by sa3d domicile, and same is not for rent, lease os sale. That he or ahe shall compiy with the folloariug concla.tions: 1. That the oovaer aad he or she alone shall act as the bni.lder for a11 phases of constructioa. � 2. That the owner ovill comply w3th all provisions of the City of Zephyrhi].ls ' ora�*+p*+�es and codea pertineat to th� buildi_ng. 3. That in the eveat various phases of coastruction ase subcontracted, he �v3.11 engage only properly licensed subcoatractors aad mill parsonaliy superviae such work_- ' 4. That ia the event the Building Inapector shall require Corrections to be made, the owaer will asaume full respoasibility fio insnre they, are made, and upon completioa arill call for a reiaspeation before proceediag with the buiiding. 5. That the owne� shall assnme fuZl responaib3lity for the construction and. mill aot expect supervision of his work from the City of �ephyrhills Hnildi.ng Departmeat. 6. That prioi to final i.nspection aay additional fees, including reinspection fees, muat be paid ia fiil.l_ A �vritten reqnest from this atfice shall constitute aa official notice to pay additional fees. 7. That the vamer shall comply wi.th al]. City,� 3tate aad Federal laa�s in regard to social aecurity, wor3�an's compeasation, lien lar�s, eto., where applicable_ 8. Tha� the owner shall comp�.y with all the safety codes iasued by the Florida IndustriaZ CommiBSioa. 9. 3tate law requ3.res construct3aa to be done try licensed coatractors. You have applied for a pexmi.t uader an exemption to �hat law. The exemption allows you, as the owaer of your property, to act as yonr own coa�sa�ctor mith certain restrictioais even though you do not have a liaense. You must provide direct onsite supervisioa of the coastruction yonraelf. You may build or i.mprave a one-family or two-family ress.deace or a farm outbuildiag. You may also build , or i.mprove a commerci.al bui.ldiag, provi.ded yonr costs do not exceed $25,0�0. The building or resideace mnst be for your owa use or occupaacy. St taay aot be built or su'bstantially improved for sale or lease. If you sel]. or ].ease a _bvilding you have I�uilt or substaatially improved yonrself within I, year after the coastructioa is complete, .the law w311 pres�e that you huilt or anbataatially improved 3f �cr sale or lease, whi.ch is a violatioa of this exemption_ � Yon may aot hire aa Zmlicenaed persoa to act as yonr contractor or to superviee people working on yonr bnilding_ It is your responsibility to make snre that people employed by you have licenses sez+77red by s�ate la� and by couaty or muaicipal licensiag Otdinan_n_e8. You may not deZegate tlie responsibility £os s�exvising work to a licensed coatsactor who is not licensed to pertorm the avork being done. Any persoa working oa youx buildiag �vho is aot licensed muat work uader yanr disect supervisioa aad mnst be employed by yau, which meaas that yon must dednct F.I.C.A. and ari�hholding tax and psovide workers' compensation for that emplayee, a11 as preacribed by 1a�v. Your aonstxuction. must comply wi.th a7.1 applicable lama, ordiaaaces, bnil.ding codes, aad zoaiag regula ' . ( '� �.•S S=�� D�� ao i� � �nuss 3�a� (a as �� pao� TfPITNSSS• `�F PERL�IIT # `Co��`b