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<br /> , � , DISCLOS�R$ STA'�`�p'�' FOR OWDffit
<br /> ,4�� , � CITY OF ZSPBYRHII+LS HIIILDING DBPARTNNl�NN'T -
<br /> � z, �U�F�ti�� �/�'�L1S�.�L have read aad fully naderstaad and ,
<br /> , agree to the provisions o� thi.s instr�p*+t. - �
<br /> The vadessigaed states and affirms that he or she is desirous o£ constructing,
<br /> renavatiag, adding to os reroofiag his ar her owa domicile, that he or ahe
<br /> actnally occupies, or will occupy by said domi.ci].e, and same is not for
<br /> sent� lease or saZe. That he or she shal.l comply mith the followiag conditions:
<br /> 1. That the oovner aad he or she alone shall act as the b�u.lder for all phases of
<br /> coastructioa.
<br /> 2. Tliat the owaer avill comply with all provisioas of the City of Zephyrhills
<br /> orcliaances aad codes pertiaeat to the bnildiag.
<br /> 3. That ia the eveat variolts phases of coastructioa ase subcontracted, ,he will
<br /> eagage only preperly licensed subcoatractors aad will personally "superv:i.se
<br /> sucli wor7c.- �
<br /> 4. That i.a the event 'Fhe Buildiag Snspector shall require �orrecti.ons to be ma.de,
<br /> the owaer will assume full respoasibility to insnre �they, are made, and upoa
<br /> � completion will call for a reiaspectioa beEore proceediag with the ]�uildiag.
<br /> 5. Tha.t the ownex� sha1Z assume full respon�ibility for the const-xnction and will ,
<br /> ' aot estpect supervision of his work trom the City of,�ephyrhills Bnilding
<br /> Depaxtment.
<br /> 6. That prior to �ina1 inspection aay additioaal fees, including reinspection
<br /> fees, must I�e pa3d ia full_ A writt�, request from this office sha.7.1
<br /> aonstitute an official aotice to pay add:i.tional fees.
<br /> 7. That the owner shall comply wi.th. a].1 City,' State and Federal laQps in regard to
<br /> social security, wori�'s compeasation, liea laws, etc., where applicable.
<br /> S. That the owner sha7.l comply wit3s all the safety codes iasued by the Florida
<br /> Indv.strial Commissioa.
<br /> 9. State law tec��;res coastritction to be done by Ziceased coatractors_ You have
<br /> applied. for a permi.t under aa exemption to that lam. 2'he' exemption allows
<br /> - you, as the owaer of your praperty, to act as yonr owa. coatsactor wi.th certai.n
<br /> restrictions evea though you do not have a Zicease. You must provide direct
<br /> onsite supervisioa of the coastraction, yovrself. You may build or improve a
<br /> one-family or two-fam3.ly resideace os a farm outbui.Idzag. You may-also bui.ld
<br /> or improve a commercial buiZdiag, provided. yota.r costs do aot exceed $25,000. ,
<br /> The buildiag or residence must be for yovr owa use er occupaaay: It may aot
<br /> be b�u.lt or svbstantially improved tor sale or lease_ z£ you sell. or lease a
<br /> .bui.ldiag you have built or substaatially improved yousself within I. year after
<br /> �e constructioa is complete, the law will presume tha.t you bu3.3t or
<br /> substaatially improved if for sale or lease, mhich is a violatioa of this
<br /> exemption. You may not h3.se aa unlicenaed persoa to act as yovr coa�ractor or
<br /> to supervise people reoriciag on your bwi.ldiag_ It is your responsibility to
<br /> make sure that people employed by you ]iave liceases rez+,;red by atate law an.d
<br /> by couaty or mnai.cipal licensiag ordiaances. You may aot delega�e tlie
<br /> responsibility for snperva.siag wark to a licen.sed coatractor who �s not
<br /> licensed to perforsa the work being doae. Aay persoa working oa you� builcliag
<br /> �vho is nat licensed must work uader your direct supervision aad mnst be
<br /> employed by yau, which meaas that you must dedtict F.I.C.A. and wit.l�holdi.ng tax
<br /> aad provi.de workers' compeasatioa for that employee, alI as prescribed by Zaw.
<br />� Yaur constrnetioa must comply w3.th aZl appl.icable Iaws, ordi_a.ances, bn.i.Idi.a.g
<br /> ` codes, and zoning regnlafia.o . ;
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<br /> 047I�F&R'S S=GI3PiTiIRS �"'���� DBZ`R �vZ�o2��4t-c�S
<br />' ADDRESS � L- �` -� �Lii � �L
<br /> P80NE �-t�
<br /> G� P�T #
<br /> _ �^'"„ SFryRDEN K.DEL CO7T0
<br /> :� •� MY COMMISSION q EE 198857
<br /> �=;;�c�' EXPIRES:June 26,2016
<br /> � �'••f'p,'f���` 6onded Thru Nofaryr Pubik Underwriters
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