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` DISCLOSURE STATEMENT FOR OWNER CITY OF ZFPHYRHILLS BIIILDING DBPARTMENT I, have read aad fully underatand aad agree to the provisions of this instrumeat. The undersigaed states and affirms that he or she is desirous of constructiag, reaovatiag, addiag to or reroofiag his or her own 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 ahall comply with the followiag conditioas: 1. That the owaer and he or ahe aloae shall act as the builder for all phases of construction. 2. That the owaer will comply with all proviaions of the City of Zephyrhills ordinaaces and codes pertineat to the buildiag. 3. That in the eveat various phases of coastruction are subcoatracted, he will engage only properly liceased subcoatractors aad will persoaally supervise � such work. ' 4. That in the event the Building Iaspector ahall require correctioas to be made, the owner will assume full respoasibility to insure they are made, and upon completion will call for a reinspectioa before proceediag with the buildiag. 5. That the owaer shall assume full respoasibility for the coastructioa and will aot expect supervisioa of his work from the City of Zephyrhille Buildiag Department. 6. That prior to fiaal iaspection any additioaal fees, includiag reiaspection fees, must be paid in full. A written request from this office ahall constitute aa official aotice to pay additional fees. 7. That the owaer shall comply with all City, State and 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 Iaduatrial Commiasioa. 9. State law requires construction to be doae by licensed contractors. You have applied for a permit under an exemption to that law. The exemptioa allows you, as the owaer of your property, to act as your own coatractor with certain restrictions evea though you do aot have a licease., You must provide direct onsite 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 building, provided your costa do not exceed $75,000. The building or residence must be for your own use or occupaacy. It may aot be built or aubstaatially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself withia 1 year after the constructioa ia 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 ual'icensed persoa to act as your contractor or to supervise people workiag on your building. It is your respoasibility to make sure that people employed by you have licenses required by state law and by county or muaicipal licensiag ordinances. You may aot delegate the respoasibility for superviaiag work to a licensed coatractor who is aot licenaed to perform the work beiag done. Aay person workiag on your building who is not licensed must work under your direct aupervision aad must be employed by you, which meaas that you must deduct F.I.C.A. aad withholdiag tax and provide workers� compensation for that employee, all as prescribed by law.� Your construction must comply with all applicable laws, ordinauces, building codes, and zoaiag regulations. , OWNER'S SIGNATURE .�'� \ � �V�V/7 DATE �(�- Z�- � S ADDRESS �G�'� l'L ��- -. PHONL `3�� '�J^I 8'31� WITNESS PLRMIT #