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DISCLOSIIRE STATffi�N'P FOR OWNF�R ' CITY OF ZLPHYRHILLS BIIILDING DEPARTMENT I� �� ,V� have read aad fully understand aad agree to the provisioas of this iastrumeat. The uadersigaed states and affirms that he or she is desirous of coastructiag, reaovatiag, addiag to or reroofing his o r own domicile, that he or she , actually occupies, or will occupy by ,Z S said domicile, aad same is not for rent, lease or sale. That he or she shall comply with the following conditions: 1. That the owner and he or she aloae shall act as the builder for all phases of conatruction. 2. That the owaer will comply with all proviaioas of the City of Zephyrhills ordinaaces aad codes pertinent to the buildiag. 3. That ia the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors. and will personally aupervise such work. 4. That in the eveat the Buildiag Iaspector shall require correctiona to be made, the owaer will assume full responsibility to iasure they are made, and upon completion will call for a reinspection before proceediag with the buildiag. � 5. That the owner ahall assume full responsibility for the construction and will not expect supervisioa of his work from the City of Zephyrhills Building Department. 6. That prior to fiaal iaspection aay additioaal fees, including reinspection fees, must be paid in full. A written request from this office shall coastitute an official notice to pay additioaal fees. 7. That the owaer shall comply with all City, State and Federal laws in 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 Iadustrial Commission. 9. State law requires conatruction to be doae by licensed coatractors. You have applied for a permit under aa exemptioa to that law. The exemptioa allows you, as the owaer of your property, to act as your own contractor with certain restrictioas evea though you� do aot have a licease. You must provide direct onsite supervision of the construction 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 building, provided your costs do aot exceed $75,000. The building or residence muat be for your owa use or occupaacy. It may aot be built or substantially improved for sale or lease. If you sell or lease a buildiag you have built or substantially improved yourself within 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 violatioa of this exemption. You may aot hire aa unTicensed person to act as your contractor or to supervise people working on your building. It is your respoasibility to make sure that people employed by you have licenses required by state law and by county or municipal liceasing ordinaaces. You may aot delegate the responaibility for supervisiag work to a licensed contractor who is aot licenaed to perform the work beiag done. Aay persoa working on your building who is aot licensed must work under your direct aupervision and must 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 must comply with all applicable laws, ordinaacea, building codes, aad zoniag re a ' s. � � OWNER'S SIGNATURE , Dp.TE 9 a� �5 � . ADDRESS S�OZ PxorrE !3�2A�.?G 5 � WITNSSS PERMIT #