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DISCLOSt7R$ STAT�NT FOR OWNER CITY OF ZEPHYRFIILLS BIIILDING DEPARTMENT I. have read aad fully uaderstaad aad agree to the provisions of this instrumeat. The undersigaed states aad affirms that he or she is desirous of constructiag, reaovatiag, addiag to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or ahe shall comply with the followiag coaditions: 1. That the owaer and he or she alone shall act as the builder for all phases of coastructioa. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordinances and codes pertinent to the buildiag. 3. That in the eveat various phases of coastructioa are subcoatracted, he will engage oaly properly liceased subcoatractors and will persoaally supervise such work. 4. That ia the eveat the Suildiag Iaspector shall require correctioas to be made, the owaer will assume full respoasibility to iasure they' are made, aad upon completioa will call for a reiaspection before proceediag with the buildiag. 5. That the owaer ahall assume full responsibility for the constructioa aad will not expect supervisioa of his work from the City of Zephyrhills Buildiag Department. 6. That prior to fiaal inspectioa any additional fees, includiag reiaspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay� additional fees. 7. That the owaer 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 requirea construction to be doae by licensed contractors. You have applied for a permit uader an exemption to that law. The exemption allows you, as the owaer of your property, to act as your own coatractor with certaia restrictions even though you do not have a licease. You must provide direct onsite supervision of the constructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. 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 own use or occupaacy. _ It may not be built or subetaatially;,improved for sale or lease. If you sell or lease a building you have built ;or substantially improved yourself withia 1 year after the coastructioa is complete, the law will presume that you built or subataatially improved if for sale or lease, which is a violation of this exemptioa. You may not hire aa ualiceased persoa to act as. your coatractor or to supervise people workiag on your building. It is your responsibility to make sure that people employed by you have licenses required by state law aad by couaty or municipal" licensiag ordinances. You may aot delegate the responsibility for supervisiag work to a licenaed contractor who is not liceased to perform the work beiag doae. Any person workiag on your building who ia not licensed must work under your direct supervision aad 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, ordiaaaces, buildiag codes, and zoaiag regulatioas. , OWNER�S SIGNATURE� � �_ DATE �f-�=�/ �20�� ADDR85S Z�.�g. GJ-s' PHONE �/,�=�'� �i �'� '3� .- ' � WITNESS � � PSRMIT # � , :��-:.