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DISCLOSII1tE STATSMENT FOR Oi�NER <br /> CITY OF ZSPHYRHTLLS BIIILDING DBPARTl�NT <br /> I, la�ve read aad fully ,�aex8��a aad <br /> agree to the pxovisiaas of this �.astrumea�. <br /> The�vadersigued etates aad affirms that he or she is desirous af coastructiag, <br /> reaovating, addiag to or reroofiag �Si�a ar her owa domicile, that he or ehe <br />' ac��a21y accupies, ar wil1. occupy by said domicile, aad s�me is not far <br /> xeati, lease or sale. That he ar she shall comply s,ta.th the falla�,riag aaaditious: <br /> 1. !Tha� the owaer aad he or she alone sha11 aet as the bu3lder far a11 phases af <br /> i� oa�truction. <br /> 2. i�Tha� the owaer will camply with alI provisioas of the City of Zephyrhills <br /> Prdsaaaees aa,d cod�s pertiaent to the buiZr�iag. <br /> 3. That ia the eveat vazious phase� of cons�ruation ere stYbcaatracted, he wi2l <br /> eugage only propexly liceased subcoatrac�oss aa.d will personally superv3se '� <br /> auch work. <br /> 4. ��hat ia the event the Su3.lding Iaapectar eha11. require corrections to b� made, <br /> the owaer will aseume fuZl respaasibility ta inaure they are made, aad upoa <br /> c�ompletion wi11 ea11 for � reiaapection before proceediag w3.th the bitildiag. <br /> 5. T�?iat the owaer eh�ll aesume full reBpoa�ibili�y for the caastsuetion aad wil2 <br /> nat expect supervieiaa oE his wark fzom the Ci.ty o� Zephyrh311s Suildiag <br /> D�epartmeat. , { <br /> 6. T�t prior to fiaal inspectioa aay additional fees, iacludfag reiaspect3oa <br /> f�es, must be paid ia �u12. �l. t�ritten xequest fram this affice sh�.Zl <br /> coastitute aa official aotiae ta gay additioaal fees. <br /> 7. Tb.�t the owaer sha11 camply with all City, State aad Federal laws ia regard �o <br /> soaial security, warkman's compensation, lien laws, etc. , whete appliaable. <br /> 8. T�at the own�r eha11 comply with aIl the safety codes i�sued by the F].orida <br /> Za%duatrial Commissioa. <br /> 9. St�ate law re�+,�res coastrue�ioa to be dane b�► licensed contractors. Yau have <br /> �p�l3.ed tor a perm3t uader an exea►ptioa ta th�.t las,r. The exemption allows <br /> yoi�, ae the owaer af your proper�y, to act as your owa contractor with aertaia <br /> re�i�trictions evea �haugh you do not have a licease. You mus� provic3e direct <br /> oa��i�e supervisi.aa o£ the coaetructa.a�n yourselt. Yau may 'build or imgrove a <br /> ane-faraily or two-fami.ly resa.dence ar a fasm outbuil8ing. Ycu may also build <br /> ar`limprove a commexcial bv.ilding, provided �our aosts do aot exceed $75,OQQ. <br /> The build3.ag os residenae mnst be for your owa use or ocaugancy. It may aot <br /> be ��built ar substas�tially improved �or sale ar leaee. It you aell ar lease a <br /> bu3��ldiag you have bui3t or svbstaatially impxoved yaurself wi.thia 1 year after <br /> thelcaastxv.ction is eomp3ete, the law vrili gresvme that you built os <br /> sub��taaGiallg 3mproved if fox sale or lease, whiel� is a violatioa o� this <br /> ex�mptiaa. You may aot hire aa unlicen�ed peraon to act as your costtractor or <br /> �o Buperviee people workiag an your builcIlirsg. It ie your ses,poaeibility to <br /> mak�� sure that g�eaple emgloyed by you have Iiceases required by state law aad <br /> by �ounty as muaicipa2 Ziceasiag ordiaaaces. You may aot de3egate the <br /> respatis3bility far eupervisiag work to a 13c�ased coatraetar wha is �at <br /> liceaeed to perfasm the woxk b�iag done. Aay persoa workiag on your buildixig <br /> whollis aot 13ceased must wark uader your direct supervision aand must be <br /> emp �oyed by you, wh3.ch meaas that yau must deduct F.I.C.A. aad withholding �aac <br /> and � �covide vaarkers' csompensation faz that �mployee, aIl as prescribed by law. <br /> Yov,x�coastruction must eomply with �11 applic�Ze laws, ordiaaaces, buildia� <br /> code , and zaaiag r lations. . <br /> otar�Rt s s=�xAmv� '``�� �7� DATE � 'G� ` 1 � <br /> �n�ss �— � r s ° ��t� t�s , -��.... �3�Y�► <br /> PHOtaS — ' <br /> i�TI�BI SS PERMIT # <br /> ' � ! <br /> � � <br />