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1 � ' ; ! , ' DISCLOSURE STATEI�NT FOR OHINSR CITY' OF ZSPIiYRHILLB Bt?ILDING DLPARTMENT I, have read and fully uaderstaad and ag�e� to the provisians of this inetrument. The vndersigaed states aad affirms th.at he or she is desiraus o� constzuctiag, reriovatiag, addiag to or reroo�iag his ar her owu domicile, that he or she actival].y occupiea, or will occupy by said domic3.le, and same is nat for rerit, lease ar sale. That he or she shall comply with the foilowing coaditiaas: i ; 1, ; That the oivuer aad he or she alon� shall aet as the builder for all phases o� ' coastruction. 2. Tha� the o"raer will camply with a21 prov3sions af the City of Zephyrhills ordiaances aud cades pertinent to the buildiag. 3. That in the eveat variaua phases of coasGruc�ion are subcoatrac�ed, he will engage aaly prapexly 1.iceased svbeo�stractors and wil3 persoaally supervise such work. 4. Tha� ia �he event the BuiZdiag saspector sha11 reguire carrectioas �o be made, the owaer will assume full respaasibility to iasure they aze made, mad upon comp].etion wi11 call for a reinspeet�ion befor� psocesd3ag T,vith the building. 5. That the ownez shail assume full reepoasa.bility far the coustruction and will � not expect supervisioa of his work £rom the City o� Zephyrhills Suildiag ' Departmemt. 6. ; That prior ta fiaal iuspectioa aay additioaal fees, includiag reinspectiaa � fees, must be gaid ia £all. A writ�ea request fraae this of£ice shall canstitute aa afficial aot3.ce to pay additional fees. 7. Tha� the owner shall comply with all City, State and Federal laws ia regard to soaial security, warkman's compensation, Iien laws, ete. , where applieable. 8. That the owaer shall aomply with all. the safety cades 3ssued by the Florida Iadustrial Commiseioa. 9. State law requirea construction to be doaa�,e by liceased contractars. You have ( appl3ed for a pesmit under aa exemp�ioa ta that law. The eacemp�ion allows � yau, as �he awner of your praperty, to act as yaur owa can�ractar sn►ith certaia res�rictions even though you do aot have a licease. You must provide direct ansite supervi.sioa af �he canstruct9.on yourself. Yau may build or imprave a one-family or two-family resideance or a farm outbuildiag. You may also build or improve a com:nercial building, provided your casta do aat exceed $75,000. The buildiag ar sesidence must be far yaur owa use or oecupaacy. It may �not be built or substaatially improved £ar sale ax lease. If yau se11 ar lea�e a � buildiag yau have buiZ� ar substantially imgroved yourself within 1 year after , the cons�ruction is complete, the law wi11 presume that you built or �� substaatially impzoved if far sale ar lease, s�rhich is a vialatiaa of this exemption. You may aot hise aa unlicensed persoa to aat ag your coatractor or to supervise people working on your buildiag. It is your respoasibility to make sure that people emplayed by you have licenses required by state Iaw and by couaty or municipal liceasing ordiaanaes. You may aat delegate the xespansibility for supervising work to a liceased coatractar wha is aat Iiceased to perform the work beiug daae. Aay person warking oa your building who ia aot liceased must work uader your direct supervisioa aad must be employ�d by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' campensatian far that employee, all as prescribed by law. Your aanstructa.oa must complg with all applieable laws, ord3.naaees, bui3da.ng codes, aad zouing regulatiaas. owr�Rr.s s��mu� �pa� �� - 02�- L� ADDRESS c 2. , Pxo� - 4 'wi�rnass �$xr�sT #