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i! . l II Y � I1 II DISCLOSIIRS STATEI�NT FOR OWNER CI7"Y OF ZBPHYRHILLS SIIILDING DEPRRTMENT Y I.�� have read aad fully uaderstand and agsee to the provisions of this iastrumeat. i' The uadersigned states and affirms that he or she is desirous of constructiag, reaovating, addiag to or reroofiag his or her owa domicile, that he or she actually occupies, or will occupy by said domicile, and same is aot for reut, lease or sale. That he or she shall comply with the followiag coaditions: 1. That the owaer and he or she aloae shall act as the builder- for all phases of coastructioa. 2. That the owaer will comply with all provisioas of the City of Zephyrhille ordinances aad codes pertiaent to the building. ' 3. ' That ia the event various ph�ses of coastruction are subcoatracted, he will engage only properly licensed subcoatractors aad will persoaally supexvise 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 proceeding with the buildiag. 5. ', That the owaer shall assume full responsibility for the coastructioa aad will not expect supervisioa of his work from the City of Zephyrhills Suildiag Departmeat. 6. That prior to fiaal iaspectioa any adc�.itional fees, iacludiag reiaspectioa fees, must be paid ia full. A written request from this office shall coastitute aa official aotice to pay additioaal fees. 7. That the owner shall comply with all City, State and Federal lavas 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 Iadustrial Commission. 9. State law requires coastruction to be doae by licensed contractors. You have applied for a permit under aa exemptioa to that law. T}�e exemption allows you, as the owner of your property, to act as your owa coatractor with certaia restrictioas evea though you do aot have a licease. You must provide direct onsite supervisioa of the coastructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuildiag. You may �lso build or improve a commercial buildiag, provided your costs do aot exceed $75,000. The buildiag or resideace must be for your owa use or occupaacy. It may not be built or substaatially improved for sale or lease. If you sell or lease a buildiag you have built or substaatially improved youreelf withia 1 year after the coastructioa is complete, the law will presume that you built or 'substaatially improved if for sale or lease, which is a violation of this exemptioa. You may aot hire aa unliceased person to act as your contractor or to supervise people workiag oa your buildiag. It is your respoasibility to �make sure that people employed by you have liceases required by state law aad �by couaty or muaicipal liceasiag ordiaaaces. You may aot de],egate the respoasibility for supervising work to a liceased coatractor who is aot �liceased to perform the work beiag doae. Any persoa workiag on your buildiag �who is aot licensed must work uader your direct superviaioa aad must be �esnployed 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 laws, ordiaaaces, buildiag codes, aad zoaing regulatioas-- pOWNER'S SIGNATURE �•`��d;� DATE ADDRSSS ��f r o � S� �� .2.�� f�1— �HONE � i�IITNSSS PSRMIT # � �I li