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!i a � DISCLOSIIRE ST�TE��NT POit OWNLR ' CITY 08 ZBPHYRHIZ�LS BII2Z�DTNG DBPART�Y�TT ' � z, h�v� read �.ad fnl].y uaderstand aad � agree ta the provieions of this a.astrumea�. , The wndersigaed states aad afiEirms �ha� he or ehe is de�iraus of canatructiag, � reaavatiag, adding to or reroofing his ox her awa damici3e, that he ar she { actually occupies, or wi1Z oceupy by saici dcmicile, aad eame is not far reat, 2easa or sa3e. That he or she sha17. comply vasth the follawiag conditioass � i 1. That the owner aad he or ahe aloae shall act a� the builder for all phases of i coastruation. � 2. That the aivaer will comply with aII provisioae af the City of Zephyrhille j ordiaaaces an8 codea pertiaent to the building. { 3. That ia the eveat various phaaes of coxastructioa are subcomtxaated, he �iZl � engage only properly licensed subcontractors aad wiZ1 persoa,alZy supervise i such work. � , 4. That ia the eveat the Buildiag Iaspectar shall requixe corsections to be made, , the awner �eill assume full reapoasibility to iasure they axe made, aad ugon � campletion will call for a reinspection before proceediag with the buildiag. 5. That th� owaer �hall assu=ne full resp�nsibil3ty far the caastruatiaa aad +a�ill asot expeet supexvi.sion of his �ark �rom the City af Zephyzhills Su�.Idiag nepartmeat. 6. That prior ta £iaal inspec�ioa any addit3oaal fees, iacludiag reiaspection �ees, mus� b� paid ia full. A written request from this a€�ice sha21 aoastitute aa off3cial aotic� to �say additiana2 feee. ?. That the av�raer sha1.3 comply t�ith al.l City, Sta�e aad Federal Iaws ia regaxd �o . social seaurity, workman's compensatian, lien laws, etc. , whete agplicable. ; 8. That the owner e�h�ll comply with all the safety aades i.ssued by the FZor3da Iadustrial Commi.ssian. 9. State law reguire� coastructior� ta be dane by licensed cantrac�ors. You have applied �or a permit ugder aa exemptioa to �hat law. The exemptiaa allows you, as the owner of your property, to act as your awa cantractor with certaia � restrict3oas evea though you do aot hav� �. licease. You must provide direet i oaaite supervisiaa of the aans�ruetioa yaurself. Yau may'builc� ar imgrove a one-f�romi3y ar twa-family resideace or a farm outbuildiag. You may alsa build � or improve a cammexcial buildiag, provided your coet�s do aot exceed $75,400. i The bu�ildiag or zesidence must be for your owa use or occupaacy: I� aiay not � be built or subs�aa�iallg imgraved tor sale or l��se. If yau sei.l or leaee a � building you have built or svbstaatiaZly improved yourseZf wi�hia 1 year after � the caastructioa is comp2ete, the l�w rai�I ,pree�ume that you built or ; subataatially improved i� far sal� or lease, wh3ch is a vialation of this ; e�cemptxaa. Yau may aot hixe aa ualicen�ed persan to aat as your coatzactcr ar to supezvise people wor•king aa yo�r b�ildiag. 3Ct ie ycur responsibility to � make s�ure that peopl� employed by you have Iicessses rec�,iiz�d by state law and ', hy cavaty ar muaicipal 3icensing ordiaaaces. You may aot deleg�te the i respaas3bility for supervieiag work to a liceneed coatzactar s,rho ia aat � lice�o,eed to perform the work beiag doae. Any persoa working oa yaur buildiag j who is zi.ot lie+ensed must wark uader your direet supervision and must be I employed by yau, which meanB that you mu�t deduct F.z.C.A. aad withholdiag tasc f and grovide morkers' compensation for that employee, all as prescribed by law. Your conetruetiaa must aosu�sly w3th all applicable las++s, ardiaaaces, buildiag ; codes, and zoaia� regulatiana. . O�iTNER'S SZG2�TATURE �f��r� DATE ADDRBS� �'� .r ' P80N8 �✓�/�- I�!1 .�. p��_`_�� , WITI�TESS PSRMIT # � , � . � I i �