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• ' , DISCLOSIIRS STATEI�NT FOR OWNLR ' , ' CITY OF ZBPIiYRHILLS SIII7�DING DBPARTN!$NT I, ��a'U('"� P �/"I?��2-� have read aad fully uaderstaad aand agree to the provisioas af this iastrumeat. The uadezsigued s�ates and affirms that he or she is desirous of eonstructing, renavatiag, adding to or reroofiag his or her owa domiaile, that he or she actually oacupies, or will occupy }sy said domicile, and same is not for rent, laase ar sale. That he ar she sha11 aamply with. th� foll.owing eaaditioas: I 1. That the owaer and he or she aloae shall aet as the builder far all phases af constructioa. 2. That the owaer will comply with all pzovi.sians of the City of Zephyrhills ordiaaaces aad codes pertinetat to the building. 3. That ia �he eveat variaus phases of coastructic�a are svbcon�racted, he will engage only groperly liaensed subcaatractors aad will personally sugervise auch work. 4. 2hat in the eveat the Building zaspeetar shaZl requ%re correctians to be made, the awaer will assume £ulI xespoasibility to iasure they are made, astd upaa completioa wi11 call fox a reinspectioa before proceediag with the buildiag. 5. That the awaes shall as�vma full respoasibility for the coastructioa aad w311 not eacpect supervisioa af his work from the City o� Zephyrhills Suildiag Departmen�. 6. That prior to final iaspectioa aay additional fees, iacludiag re3.aspeation fees, mus� be paid in full. A writtea raquest from thie office shall eaas�itute aa afficial aotice ta pa�r addi�ioaal fees. 7. That the owaer shall comply with all City, Sta�e and Federal laws ia regard to social seaurity, workman's compensatianr Zien laws, etc. , where applicable. e. That the owaer shall comply `vith all the eafety codes i�sued by the Florida Industrial Commisaion. 9. State law requires construction �o be doae bg liceased caatractors`. Yau have applied for a permit uader aa exemptioa ta that law. The exemptian allow� you, as the awuer of yaur property, to aa� as yaur owa eoatractor with certaia zestrictioas evea �hough you do aot have a license. You must pravide direat oasite superva.sion of tlxe coastructiaa yourself. Yau may build ar imprave a one-£amily or �wo-�amiZy residenae or a farm outbuildiag. You may also bu31d or improve a cammezcial buildiag, provided your coets da aot exceed $75,000. The buildiag or residenee must be for your awa use or ocaupancy. It znay aot be built or su,bstaatial].y improved for sale or lease. xf yau se11 or lea�e a buildiag you have built ar substaatial,ly improved yaurself w�ithi.n 1 year after the oonstruction is complete, the Zaw wil3. presume that you buil� or substaatially impraved if for sale or lease, which is a violatioa of �his exemptioa. Yau may aot hire an ualicensed persoa �o aet as your coa�ractor or �o supervise people workiag oa your buildiag. It i.s your respoasibil3.ty �o make sur� that� people emg3oyed bg you have liceases required by state law and by caunty or muaic3.pa1 licenaing ordiaances. You may nat delega�e the respousibility for supervisiag work to a liceneed contractor who is not Ziceased to perfcrm the work being daae. Any gersoa wozking oa your buildiag who is no� licensed must work under your direc� supervision and must be employed by you, whieh means that you must deduet F.I.C.A. and withhaldiag ta�c and provide woxkers� campensation for that employee, a1Z as prescribed by 1aw. Your construction must comply with all applicable laws, ordislaacee, buildiag codes, aad zoai.ng regulatiaas. � OWNER'S SIGNATURE �DAfiE �..Q,t/i c� c�-U/S' �ADDRESS • / �,, �PHONB TnIITNBSS 1.�� PSRMI'T # I.��,'�,