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� ( � � . � � i . DISCLOSIIRS ST1aaTEMENT FOR :OT+�NSR � . CITY QF ZEPFiY'RHII�LS BIIZLDING I}BPARTMF�AIT � I, !1✓AL/+� GiJ ��'f"C"y have read and �ully uaderstaad aad I ' agr`�e to th� provisioas of this iastrument. �� Theivadessigaed states aad affirms that he or she is d�sirous af coastructing, rea vatiag, addiag ta or r�roofiag his or her owa domicile, that he or she , acti�ally occupies, or wil7. oecupy by said domicilej aad same is aot for rent, lease ar sale. 3'hat he ar she shall camply with the following coaditiaas: � � l. (That the o�,raer and he or she alone shalZ act as the bui2der for all phases of j cons�ruction. i 2. ITha� the owner wi11 comply w�.th aZl provisioas af the City of Zephyrhills i ordiaaaces aad codes pertiaeat �o the buildiag. � � 3. �That in the event variaus ghasee of constructioa are subcoutracted, he wi11 engage only properly lieeased subcoatrac�ors aad wilZ perso�oally supezvise ' such work. �. That xn �h� event the Suildiag Iuspector sha23. r�quire corrections to b� made, the owaex will assume full respoasib3lity to iasure they are made, and upoa completioa wi11 ca11 for a xeinspectioa before proceediag with the buildisig. 5. Tha� the owaer shall assume full r�sponsibility far the coastructioa and �vi11 aot expect supervisioa of his work from the City af Zephyrhills 8uilding Depast��nt. 6. That priar to final iaapect3on aay additioaal fees, includiag reiaspection fees, must bs paid ia Eull. A writtexi request fram this office shall aonstitute aa off3,cia1 rsotice ta pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to � soeial security, workman's camgensatian, Z�en laws, et�. , mhere appliaable. ' 8. That the owaer shall comply with all the safety codes issued by the Florida , Iadustrial Commissioa. 9. State law requires conetructioa to be done by liceased contractors. Yau h�.ve applied for a permit un,der aa ex�snptioa to that law. The e�cemptiaa a].1ows � ou, as the owaer of your property, �o act as yaur awn contractor with certain sestrictions even though you do uot have a licease. You must psovide direct lansi�e supersrisioa of �he aonstruetioz� yourself. Yau may build or improve a �one-Eamily or two-family reaideace or a farm outbuildiag. You may also build , or improve a commercial buildiag, provided your costs do aot exceed $75,000. e bui3diag or resideaae must be foz yaur awa use ar occupancy. It may aot { � e built or sulasta�tial].y improved far sale or lease. If you sell or lease a F uilding yau have bui2t ar substaatial�.y impsaved yaurse].f wsthin 1 year a�ter Ithe coast�cuction ie complete, the law will presume that you built or �Substantially improved if for sale or lease, which is a violation of �his �xemptioa. You may aot hir� an uanliceased peraoa �o act ae your contractar or to su,pervise people workiag on yaur buildiag. It is your reepoasibility to , G ake sure that people ea►ployed by you have lieenses required by state lat,r aad � y couaty or muaicipal ].iceasiag ordiaances. You may aat delegate the � esponsibility for supervisiag work to a li.censed cantractos who is aot , icerised to perform the work beiag done. Ray persoa working on your building ' ho ie aot liceased mus� work vader yaur direc� superviaion aad muat be � loyed by you, whiah meaas that you must deduct F.I.C.A. aad wi.thholdiag ta�c , i nd provide warkers' compensation for that employee, a1Z as paresaribed by Zmw. ' our coas�ructioa must aomplg with all applicab2e Ia�s, ordinaaees, bui.3diag � j Iodes, and zoaiag re atio . il �i OWNER'S SI�NATURE �� DATE � i�iDDRSSS � Ei4N$ iITNEBS PBRMIT # E � I