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DISCLOSIIRE STATEMENT FOR OWNER CITY OF ZSPIiYRHII,I�S BIIILDIN� DEPARTML�I+IT . I, have read and fully uaderstand aad agzee to the provisions o� thie iastrumeat. The uadersigned states aad affirms that h� or she is desixaus o� constructiag, reaovat3ag, addiag ta or reroofiag his ar h�r owa domicile, that he or she aetua2Zy accugies, or will aacupy by said domiaile, aad sam� is nct for reat, lease or sa1e. That he or she shall camply with the followiag coaditioas: I. Tha� the owaer aad he or she aloae �hali act as the builder far all phases of conetructioa. 2. ThaC the owaez wil]. comply with �Zl provisioa� af the City of Zephyrhills ordiaances aad codes pertiaent to the buildiag. 3. That ia the event various phasea of coastructioa axe subcozztraa�ed, he wi11 eagage auiy properly 2iceaeed subeoatractors and will persaaally sup�rvise such work. 4. That ia the event the Building Saspectas s2sall require correetioas ta be made, the owaer will aseume �ull respoasibility to :tasure they ase made, aad upan completioa wa.11 call for a reiaspection before praaeediag wxth �he buxldiag. 5. That� the owaes shall aasume full respoasibility far the coastructioa and will aot expect su,pervieioa of his wark from the C3ty a� Zephyrhills Suildiag IIepartment. 6. That� prior ta fiaal iaapectioa aay additional feea, includi,ng reinsp�ction fees, must be paid in full, A writt�a request from this af�iee shall coastitu�e aa official aotice to pay addi�ioaal fe�s. 7. That the owaer sha11 camply with all City, State an8 Federal lavas ia xegasd to soeial. seeurity, workman's compensatzon, lien laws, eta. , where appZicable. 8. Thati the owner sh�ll comply with all the safe�y cades issued by the Florida � Iadustrial Cominiseian. 9. State law requires construc�ioa to b� doae by licensed coatractoxs. �'ou have applied for a p�rmit uader aa exempt3oa �a that law. The exemption allows you, as the owaer of your property, to act as yaus own contractor with certaia restrictions evea though you do aot have a licease. You muet provide direct onsite supervisioa of �he eanstructiaa yourself. You may build or improve a oae-family or two-family reaideace ox a £arm autbuilding. You may also build or improve a cammexciaZ buildiag, provided your costs da noti �ceed $75,000, The buildiag ar residence must be for youx owa use or oacupaacy. It may aot be built or aubstas�tially improved far sale or lease. If you se11 or lea�� a ` buildiag you hav� bu31t ar sut>s�aatially impraved yaurself x*3thia Z year after the coast�ruction is complete, the law wil]. presume that you built or subs�ant3ally impxoved if foz sale or lease, which is a violation of ,this exemption. Yau may aot hire an ualicensed person to act as your coatxactoz or to supervise people workiag oa yaur buildiag. It a.a yaur respoasibility Go � malse sure tha� people emgloyed by you have liceases required by stat� law anci �, � by covaty or muaicipal liceasiag ordiaancea. You may not delegate the ' responsibility for supervising work to a liaertsed cont=actar who is aot � licensed to p�rform the work beiag daae. Aay persaa war]eing on your buildiag �, who is aat liceased must woxk uader your direct supervision aad must b+e � employ�d by you, which m�ans that gou mus� deduct F.I:C.A. assd w3thhalding t� snd provide warkes�s' campensation for tha� employee, a11 as presczib�d by 1aw. Your eanstrua�ioa must comp2y with a12 applicable laws, ordi7aaaces, bvi3ding codes, aad zosaiag regulations. OWNER'S SS�t7R� �t",�� 23ATE �� ADDREBS ' �,. ( ✓ ` (-�.��" �xaxs � 3_3 w�'� � --2'�� �a=�rnass �sxrsxx #