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� � , DISCLOSDRE STATEMENT FOR OiVNSR CITY OF ZEPHYRHILLS SIIILDING DE:PARTMENT _, have read and fully underatand and agree to the provisioas of this instrument. The undersigaed states and affirms that he or she is desirous of constructing, � renovatiag, addiag to or reroofiag his or her owa domicile, that he or she actually occupies, or will occupy by said domicile, and same is not �for ' reat, lease or sale. That he or she shall comply with the following condstioas:`�� 1. That the owaer and he or she alone shall act as the builder for all phases of construction. � 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertiaent to the building. 3. That ia the eveat various phasea of construction are subcoatracted, he will engage only properly liceased subcontractors aad.will personally supervise such work. - 4. That in the eveat the Building Iaspector shall require corrections to be made, the owaer will assume full respoasibility to iasure they are made, aad upoa completion will call for a reiaspection before proceediag with the building. 5. That the owaer shall assume full respoasibility for the constructioa aad will aot expect supervision of his work from the City of Zephyrhills Building Departmeat. � 6. That prior to final inspection any additioaal fees, includiag reinspectioa fees, muat be paid in full. A written request from this office shall constitute an official aotice to pay additional fees. 7. That the owner shall comply with all City, State aad Federal laws ia regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owaer shall comply with all the aafety codes issued by the Florida Iadustrial Commiasion. 9. State law requires constructioa to be doae by licensed coatractors. You have applied for a permit uader aa exemptioa to that law. The exemption allows you, as the owner of your property, to act as your owa contractor with certaia I restrictions evea though you do aot have a license. You must provide direct oasite supervision 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 buildiag, provided your costs do not exceed $75,000. The building or residence must 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 building you have built or substaatially improved yourself withia 1 year after the coastructioa ie complete,. the law will presume that you built or substantially improved if for sale or lease, which is a violatioa of this exemptioa. You may not hire aa unliceased persoa to act as your coatractor or to aupervise people working on your buildiag. It is your respoasibility to make sure that people employed by you have licenses required by state law and by couaty or muaicipal licensiag ordinances. You may aot delegate the responsibility for supervisiag work to a liceased contractor who is aot liceased to perform the work beiag done. Any person workiag oa your buildiag who is not liceased must work under your direct supervisioa and must be employed by you, which meaas 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, buildiag codes, and zoning regulations. ' OWNER'S SIGNATURE (� _ DATE � � � �G/6 ADDRESS � U PHONE — / �- . . . .., , WITNESS PERMIT #_