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. • DISCLOSIIRE STATII�NT FOR OWN�R CITY OF ZEPHYRHILLS BIIILDING DEPARTMENT I, � ��Q,� �l.,l,trQ-� have read and fully uaderstand and � agree to t�visions of this instrumeat. , The undersigned states and affirms that he or she is desirous of constructing, renovatiag, addiag to or reroofiag his or her own domicile, that he or she 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 followiag conditions: 1. That the owner and he or she aloae ahall act as the builder for all phases of construction. 2. That the owaer will comply with all provisions of the City of Zephyrhills ordinaaces and codes pertiaent to the building. 3. That in the event various phases of coastruction are subcoatracted, he will engage oaly properly licensed subcoatractors and will persoaally supervise, ' ' such work. 4. That in the eveat the Buildiag Iaspector shall require correctioas to be made, the owner will assume full responsibility to insure they are made, and upon completioa will call for a reiaspectioa before proceediag with the building. 5. That the owaer shall assume full responsibility for the construction aad will not expect supervision of his work from the City of Zephyrhills Building Departmeat. '� 6. That prior to final inspectioa any additional fees, iacluding reiaspection fees, must be paid ia full. A written request from this office shall � coastitute 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 owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires constructioa to be done by licensed contractors. You have applied for a permit uader aa exemption to that law. The exemption allows you, as the owaer of your property, to act as your owa coatractor with certaia restrictioas even though, you do aot have a license. You must provide direct onsite supervision of the coastructioa yourself. You may build or improve a oae-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 occupancy. It may not ' be built or substantially improved for sale or lease. If you sell or lease a � buildiag you have built or substaatially improved yourself withia 1 year after the coastructioa 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 not hire an ualicensed person to act as your coatractor or to supervise people working oa your building. It is your responsibility to make sure that people employed by you have liceases required by state law aad I by couaty or municipal licensing ordiaances. You may aot delegate the � respoasibility for supervising work to a licensed coatractor who is not liceased to perform the work being done. Any persoa working oa your buildiag � who is not liceased must work under your direct 8upervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all applicable laws, ordiaances, building codes, aad zoniag regulations. , OWNER'S SIGNAT� 1 a""- DATE 3 �� I� ADDRESS (7 PHONE (�3 d WITNESS PERMIT #