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i i � , DISCLOSUXE S�ATEMENI' FOR OWNER � CITY OF ZSPIiXRHILLS Bt3II�DING DSPA1tR'I�N'P �, ��rc� �� j��Q� h�ve read aad fully uaderstaad aad agree to the pravisioas af this iastrumeat. The �'uadersiga�d states aad affisms that he or she is desirou� o� cons�ructiug, =eaavatiug,, addiag ta or zerQofzag hxs ox her awa dnmicile, th�t he Qr ehe act �all.y odcupies, or will occugy by aaid domic3le, sad same a.s aot for reat, lea�e ar��sale. That he or she sha21 comply with the follawing aoaditioae: 1. � hat the owaer aad he or ahe alone shall aet as the builder far a11 phases of oastructian. 2. �hat the ovrn�r will comply with a13 g►rovisions of �he City cf Zephyrhills rdinaaces and codes pertiueat to the bui3.diag. 3. '�hat iaci the eveat various phases of coastruction �re subeoatracted, he will i �nga�e aaly propexly liceased subcoatractors ax�.d will persaaally supervi�e �uch work. 4. �Y►at ia the eveat the Suildiag Inspeetar sha21 require correations to be made, �he owner �ill asszun� fu12 respoasibi2ity to insure they �re ma8e, and upon completion will call for a reiaspection before prac��ding with the buildiag. 5, Tb,at the owaer �h�ll aseume :Eull seepoasibility far the constructian aad �i.1Z �ot eacpea� superv3sion of hia work Erom the City of Z+ephyrhilis Suildiag Departmezit, b. �hat prior to 7Eiaa1 inspeotioa aay add�itioa2sl feee, i.acluding reitispection �ees, must be paid ia full. A. writtea request from this affice sha1Z c�nstitute aa official aotice ta pag additioaal fees. 7. �Jhat the aoraer sha31 comply with a1Z City, 3tate aad Federa3 Iaws ia regard to s�iocial secuxi.ty, workman's campensatian, Iien laws, etc. , whe�e appli.cable. $, R�hat the owner sha�Il camply with �I1 the safety codes ieoued by the Florida I�ndustrisl Commissioa, 9. S�tate lara► sequire� coastructia� to be done b� 13ceased contractors. Yau have app2ied fcr a permi� uader aa exea►ptioa ta that iaw. The exempt3.oa a.11ows y°pu, as �he awner of your property, to act as your owra, coatractor with certai� r�estrici�ions even though you do aat have a license. You mu�t prov3.de dixecti oasite supervision of the cona�ructsau yourself. You may 'bui2d or imprave a oae-fam3.ly or taro-family reeidenae or a fasm aui:buildiag. Yau may also bu3.Zd or improve a eamm�sc3a3. buildiag, provided your coets do aat �xceed $75,000. The bui2diag ar resid�nce must b� for your owa use or occupaacy. It may aot be built or substantially improved �or s�le or lesse. Zf you �ell ar lease � buildiag you have built or substaatially impraved yourself w�.thia 3. year afte= the constructioa is coaip3ete, the 1�� wi11 psesume that you built or s�bstantially improved if �or ��le ar l.ease, which ia a violatiaa of thfs e�temption. You may aot hire aa ualiceased persoa to act as your caatraatox ar , to supervise people warkiag oa yaur buiidiag. =t is your respansibila.ty ta m�ake stare that people empioyed by you have lieeases required by state law aad b� aou�ty or muaiexpal liceasiag ordin.aaces. You may aot delegate the respaasibility for �upervi�ing wark to a liaensed coatrac�or mho 3s aot 1�cease8 to perform the work being done. Aay persoa teork3ag on yaur building w�o is aot lic�as�ed mus� wark wnder your disect soperv3sioa aad mast be em�ployed by you, whiah meaas that gou mu�t deduct F.I.C.A. aad withhaldiag tax ' and prava.de work.ersr compeasation for that employee, alI as prescribed by law. Your canstruetiaa muet comply with all applicable 1a�ss, ordinauces, buildingr co�des, arid zaa3.ng re�ulat3ons. ' . , �� s + OWNER�S SIGNATt7RE Q/ ,t� ��_�"„�� ` DATE �!'J /r ""' f � ADaR8S8�8�c� �L.�R�f� '�t.��' --�-- PIiONB �`3'/3 s"'��..5� � '��..5� _ WI��'PT8�3 PBA�"!IT # � � . I i �