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DISCLOSUR$ STATED�NT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT )�� c L�,��- � I. i have read aad fully understand and agree to the provisions of this iastrument. i The undersigned states aad affirms that he or she is desirous of constructing, renovatiag, adding to or reroofiag his o er own domicile, that he or she 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 owaer aad he or she alone shall act as the builder for all phases of constructioa. I 2. That the owaer will comply with all provisioas of the City of Zephyrhills ordinances and codes pertiaent to the building. 3. That ia the eveat various phases of constructioa are subcoatracted, he will engage only properly licensed subcontractors and will persoaally supervise I i � such work. � 4. That ia the eveat the Buildiag Iaspector shall require correetiona to be made, , the owner will assume full respoasibility to iasure they are made, aad upon completion will call for a reiaspection; before proceeding with the building. 5. That the owaer shall assume full respoasibility for the construction and will not expect supervision of his work fromithe City of Zephyrhills Building Departmeat. � 6. That prior to final inspection aay additioaal fees, including reinspection fees, must be paid in full. A written 'request from this office shall constitute an official aotice to pay additional fees. 7. That the owaer 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 Industrial Commission. ' 9. State law requires coastruction to be doae by licensed coatractors. You have applied for a permit under an exemptioaito that law. The exemptioa allows you, as the owaer of your propesty, to act as your owa coatractor with certaia restrictions evea though you do aot have a license. You must provide direct oasite supervisioa of the coastructioa 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 costs do aot exceed $75,000. The buildiag or resideace must be for your owa 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 substantially improved yourself within 1 year after , the constructioa 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 aot hire aa ualicensed person to act as your contractor or to supervise people working on your bui�lding. It is your responsibility to make sure that people employed by you h�ave licenses required by state law aad by couaty or municipal liceasiag ordiaaaces. You may not delegate the respoasibility for supervising work to ia licensed contractor who is not licensed to perform the work being doae;. Aay person working on your buildiag who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. aad withholdiag tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all �applicable laws, ordiaances, buildiag codes, and zoning regul 'ons. i OWNER'S SIGNATURE .Ji �� DATE � /�//� ADDRESS PHONE - WITNESS � PERMIT #