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DISCLOSIIRE STATEI�SNT FOR OWNER CITY QF ZBPSYRHI7,LS BIISLDING DBPAItTP2ENT I. ��}��:,.: � �f�t,vGf,f have read and fully uaderstaud aad agree to the provisioas ot this ine�z�umeut. The undersigaed statee aad aff3,rms that he or she is desirous at coustructing, reaovatiag, adding to or rerooEiag his or her own domiaile, that he or she aatually aceupi�s, ar will oceupy by saa.d domieile, and same is not far °renG. lease ar sale. That he ar she shall comply with the followiag coad3tioas: I. fihat the owaer and he ar she alone shall act as the builder for all phases of coastruc�ion. 2. That the ownear will comply with alI pravi.sions af the C�.ty af Zephyrhills ordinaaces and codes pertineat ta the building. 3. That in the eveat various phases of coas�ructiaa are subeoatsacted, he �i.Zl eagage omly properly lfcensed subcoatxactars aad will p�ersoaally aupervise such work. 4. That in the event the Build3ng Zaspeator shall require correctioas to be made, the awaer will assvme �ull respaasibility to iasure they are made, axxd upoa completion will call for a reinspect3.an befare prcceediug with the building. 5. That the owner shall aaeume tull reeponeib3li�y for the constructiioa aad will uot expect supervis�on cf his wosk from the City of ZephyrhiZls Suilding T�epastmeat. 6. That priar to �iaaZ iaspectioa auy additioual fees, iacludiag reiaspection £ees, must b� paid ia fu11, A w,z4itten request fram this af£iae �ha31 aoas�itute an official aotice to pay addi�ional feee. ?. That the owaer shall compiy with aZl City, State aad Fet3eral 2aws zn regard ta soeia2 seaurity, warkman's compensation, lien laws, etc. , whete applicable. 8. That the owaer shall comply with all the e�fety codes ieeued by �he Florida xnduetriaZ Ccmmission. 9. State law requires oons�ructioa tio be done by licensed contractors. You have �pplied foz a perm3.t uader aa exemptioa ta that la�+r. The e�cemption a3.Iows you, as the owaer af your pr+aper�y, to act as your awa coatractor with certaia restrictious evea though you do aat h�ve a licease. You mus� provide direot onsit� supervisiaa of the eaastructiou- your�elf. You may 'build oz improve a ane-£amily or �wo-family reaideace or s fasm outbuildiag. Yau may also build ar imprave a cammexcial buil.diag, provid�d you�c aas�s do aat exceed $T5,000. The buildiag or resideace must be for �our owa use ar occupaacy. It may aat be built ar aubstan�ially im,pzoved for sal� or lease. If you sell or lease a buildiag gou h�ve buiZt or stsbstaatially imgroved youreelf withia 1 y�ar after �he caastructioa io complete, the law will presume �hat you built or � substaatial�y improved it for sale ar lease, wh3ch is a vialatian of this eacemptioa. You may aot hire aa ualiceansed peraon ta act as your coatr�ctor or �o superv3se people workiag oa your buildiag. It is ,you= rs$poasibili�y to make tsla.re that peopl� ettiploy�d by you have liceasea r�quired by s�ate law and by couuty or munici.pal liceas3ag ordiaaacea. Yau may aot delegate the respcasibility for sup�rvisiag c�ark .to�a 13.censed coatractar who is aat liceaeed to perform the work beiag done. Aay pereoa working on your buildilsg who ia aot lic�nsed must work under your direct �supervis3an and mnst be empZoyed by you, which meaas that yau must deditct B.S.C.1�., and wi�hholding tax az�d provide workers� compensation for t.kiat employee, all' as prescribed by law. Your coastructioa must camplY with a13. app3. cable Iaws, ordiaaaees, building codes, aad zoni,ag regulati ns. . �...-. .� OWNER'� SIGNATURE � DATE -/�'s- �� A.1)DRESS ��a!.� __ �'I�f}N8 �l� �,f�- ��45�� I ws�rr$ss ��x� # , 1 � � . �