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t % DISCLOSURE STATEMENT FOR OWN�R CITY OF ZEPHYRHILLS BIIILDING DBPARTMEN'P I, have read and fully uaderstand aad a e o the provisioas of this instrument. The uadersigned states aad affirms that he or she is de8irous of constructiag, renovatiag, adding to or reroofing his r her own domicile, that he or ahe actually occupies, or will occupy by said domicile, aad same is not for reat, lease or sale. That he or sh hal comply with the followiag 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 provisiona of the City of Zephyrhills ordinaaces and codes pertinent to the buildiag. 3. That ia the event various phases of coastructioa are subcontracted, he will engage only properly liceased subcontractors aad will personally aupervise such work. 4. That ia the eveat the Buildiag Iaspector shall require corrections to be made, the owner will assume full responsibility to iasure they are made, and upoa completioa will call for a reinspection before proceeding with the buildiag. 5. That the owaer shall assume full responsibility for the coastruction aad will aot expect supervision of his work from the City of Zephyrhills Suildiag Departmeat. 6. That prior to final iaspectioa aay additioaal feea, includiag reiaspectioa fees, must be paid in full. A writtea request from thia office shall coastitute an official notice to pay additional fees. 7. That the owaer shall comply with all City, State aad Federal laws in 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 constructioa to be doae by.licensed coatractors. You have applied for a permit under an exemptioa to that law. The exemptioa allows � you, as the owaer of your property, to act as your owa contractor with certain reatrictioas evea though you do not have a license. You must provide direct oasite supervision of the constructioa yourself. You may build or improve a one-family or two-family resideace or a farm outbuildiag. You may also build or improve a commercial buildiag, provided your costs do aot exceed $75,000. The buildiag or reaidence must be for your own use or occupancy. It may not be built or aubatantially improved for sale or lease. If you sell or lease a buildiag you have built or subatantially improved yourself withia 1 year after the construction is complete, the law will presume that you built or substantially improved if for sale or lease, which is a violatioa of this exemption. You may aot hire an ualicensed persoa to act as your coatractor or to supervise 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 county or municipal licensing ordinaaces. You may aot delegate the responsibility for supervisiag work to a liceased contractor who is not licensed to perform the work beiag .doae. Any person working on your building who ia aot licensed must work under your direct supervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholdiag tax and provide workers' compensation for that employee, all as prescribed by law. Your coastructioa must comply with all applicable lawa, ordinaaces, building . , codes, and zoniag regulations. � - OWNER�S SIGNATURE / DATE /�i "/ ��J� ADDRESS PHONS WITNESS �✓l� PERMIT # /b ��