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�,.; ► DISCLOSIIRE STATBM'LNT FOR OiA�R CIfiSC QF ZBPHXRHII,LS SUIiaDING DBPAR'tR�' z. i�L{`G`'A�� UJ�NGp'Q!� have zead aad fully uaderstaad aad agree to th� pxovisiaae ot this i.astrumea�. The ,�a�rsi��a states aad a�firms that he or she ie desirous of cons�ructing, � reaovating, addiag to or reraofing his or her awn damicile, that he or ahe ae�ually aceupies, ar wi.21 oeeupy by saic� dom3.eile, aad same is uat far reat, lease or s�le. Thab he or she shall aamply with �he follcnviag aonditiaas: 1. That �he owner aa.d he or she alone ehall act as the builder far a11 phaees of �, caastructioa. � 2. That �he owner +�ri13. comply with all pravis3.oas af the City af Zephyrhills , oxd3aaaees aad codes ger�iaent �o the buildiag. 3. That ia the eveat varioue phasee af co�ns�ructiom are subcaatsaeted, he �*i11 eugage oaly properly liceased subcontrac�ors aad will pex�oaally eupervise such work. � �. That iu the eveat the 8ui2diag Iaspectar sha11 require correc�iaas ta be made, the o�,mer wi11 aseume fu11 re�pcnsib3.2ity ta s.asure they are a�de, aad upoa campletioa w311 call for a reinspect3on before proceediag with the buildiag. 5. That the owaer sha11 aesume f�all reepoasa.bility far �he con�tructioa aad will aot expeat supenrision of his wark fzom the Catty o� Zephyrhills Suildiag Depastmeat. � 6. That prior to fi,aal ia�pectioa auy additioaal fees, iacludiag refaspectioa , fees, mu�t be paid ia f�ll. A writtea request �rom �his of�iae sha21 coaetit�ute aa official aotice to pay additional fess. 7. That the owaer sha11 comply with all City, State ara,d Fedexal laws ia regasd to � = saaial seaurity, workman's aompensation, lieri laws, etc. , whete applioable. 8. That the c�waa�ex sha�.l eamg2y vaith. all �he sa��tg �odes ieeued by the Florida Iadu�trial Comm3.ssiaa. 9. State law requises canstruct�os� to be done by liceased contractars. You have applied tor a permit under aa exemgtioa to that law. The exemptioa allows you, as the ov�ner af your proper�y, to act as your owa coatractor with certaia restrictions even �haugh you do ao� have a licenee. You must provide dizeat ansite supervisioa af the caastruatioxt youraelf. You may'bui38 oz imprave a one-�'�ms.Zy or t�o-family xesideaee ar a fazm outbuildiag. You may also bui3d � or impsove a commercial building, provided yous coBts da act exceed $75,04p. � :T.'he build3.ag or resideace must be for your osva uae ar occupaacy. It may aot I be built ar substantially impraved fox sale or leaee. I� you sell ar leaee a bui3diag you have built or substaz�tially i.mpraved yourse3f withia 3 year after the caastxuetioa is complete, �he law will psesvme �hat you built cx substaatially improved if �or sale or lease, wha.ch 3s a violation o� this exemptioa. You may aat hire aa uxalicensed persoa to act as your aoatractos or to supervise people workiag aa your buildiag. It is your responsibility to make sure that peaple empZayed by yau have liceases required by state law aad by aounty ar muaicigal licensiag ordiaaaaes. You gtay aot de2egate the respoas3bility far eupervisiag work ta a liceased caatractor tvho 3.s aat � licensed to pe�farm the work beiag done. Aay person workiag on yaur bnilding ; arho is uot liceased must work uader your direct supervision and must be i emplayed by you, which means that you must deduct F.I.C.A. aad withholdiug ta�c �ud pxavide workers� a�pensati.on for that employee, �11 as parescribed by law. Youx constructioa must comply with all agplicable laws, ordiaaa.ees, bu3lcliag I codes, aad zaniag regulations. . E I -7 � OYdNER�S SIGNJ4'i`URE ,� DATE � aZ�, c�� / � ADDREBS � PHOIQS - -� � WITNBSS PBRMIT # ' ' � . I � �