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: • DISCLOSURFs STAT�NT FOR OWNSR CITY OF ZEPHYRHILLS BIIILDING DBPARTN�NT I, �Ar�t'z S ` ` C F F have read aad fully understand and agree to the provisioas of this instrument. The undersigned states and affirms that he or she is desirous of constructiag, reaovatiag, addiag to or reroofiag his or her own domicile, that he or ahe actually occupies, or will occupy by said domicile, aad same is not for reat, lease or sale. That he or she shall comply with the following conditioas: 1. That the owaer aad he or she aloae shall act as the builder for all phases of construction. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordiaances and codes pertinent to the buildiag. 3. That ia the event various phases of constructioa are subcontracted, he will engage only properly liceased subcoatractors and will persoaally supervise such work. 4. That ia the eveat the Suilding Iaspector shall require corrections to .be made, the owaer will assume full respoasibility to iasure they are made, and upoa completion will call for a reinspection before proceediag with the buildiag. 5. That the owner shall assume full responsibility for the construction and will aot expect supervision of his work from the City of Zephyrhills Buildiag Departmeat. 6. That prior to fiaal iaspection any addit'ional fees, iacludiag reiaspectioa fees, must be paid ia full. A written request from this office shall constitute an official notice to pay additioaal fees. 7. That the owner 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 owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by liceased contractors. You have applied for a permit under an exemptioa to that law. The exemptioa allows you, as the owner of your property, to act as your owa contractor with certain restrictions even 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 building, provided your costs do not exceed $75,000. � The building or resideace must be for your owa use or occupancy. 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 withia 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 unliceased person to act as your coatractor or to supervise people workiag on your buildiag. It is your respoasibility to make sure that people employed by you have liceases required by state law and by couaty or muaicipal licensiag ordinances. You may aot delegate the responsibility for supervising work to a liceased contractor who is aot liceased to perform the work beiag doae. Aay person workiag oa your building � who is aot liceased must work under your direct aupervisioa aad must be employed by you, which means that you must deduct F.I.C.A. aad withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all applicable laws, ordinaaces, building codes, and zoaiag regulations. OWNER'S S IGNATURE �y'—^ DATE S" � '-' 7�� P ADDRESS g0 32 '!/e�! � [-�+�1 G f�1/r . PHONE �►3-�32 -��5 3 WITNESS ' PERMIT #