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, � DISCLOSIIRE ST�T�NT FOR OWNER ` CITY OF ZEPHYRHILLS BIIILDINYG DEPARTNlSNT ,Q 1V a�ro 1�"'�""10 r0$ I. `�c��-�r,`ur� �rv�broS ce,s�a have read and fully understand and agree to the rovisioas of this instrument. The undersigned states and affirms that he or she is desirous of constructing, reaovatiag, adding to or reroofiag hia or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is aot for rent, lease or sale. That he or she shall comply with the following conditioas: 1. That the owaer and he or she aloae shall act as the builder for all phases of construction. 2. That the owaer will comply with all proviaioas of the City of Zephyrhills ordiaaaces aad codes pertinent to the buildiag. 3. That in the eveat various phases of coastruction are subcontracted, he will engage only properly licensed subcoatractors aad will persoaally supervise such work. 4. That in the eveat the Suildiag Iaspector shall require corrections to .be made, the owaer will assume full respoasibility to insure they are made, aad upon completion will call for a reiaspection before proceediag with the building. 5. That the owner shall assume full responsibility for the coastructioa aad will aot expect supervision of his work from the City of Zephyrhills Building Departmeat. 6. That prior to final inspection aay additional fees, iacludiag reinspectioa fees, must be paid in full. A writtea 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 safety codes issued by the Florida Industrial Commission. 9. State law requiree construction to be doae by liceased contractors. You have applied for a permit under aa �acemption to that law. The exemptioa allows you, as the owaer of your property, to act as your own contractor with certain restrictions eveu though you do aot have a license. You must provide direct oasite aupervisioa of the coastruction 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 aot exceed $75,000. The buildiag 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 buildiag you have built or subatantially improved yourself withia 1 year after the coastruction is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violation of this exemption. You may aot hire an ualicensed persoa to act as your contractor or to aupervise people workiag on your buildiag. It is your responsibility to ' make sure that people employed by you have licenses required by state law and by couaty or municipal licensiag ordinaaces. You may not delegate the respoasibility for aupervisiag work to a licensed coatractor who ia not � licensed to perform the work beiag done. Any person workiag on your building � who is not liceased must work under your direct supervision and must be employed by you, which meaus that you must deduct .F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all app icable laws, ordiaaaces, building codes, aad zoniag regulatioas. �1, ��c I�� OWNER'S SIGNATURE GCrt DATE � ADDRESS `� . `Z � y I 3 5�� PHONE �I'�.-'�(7 ti'F-� a,LI,3 WITNESS PERMIT # l