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� y <br /> DTSCLOSDRE ST�TEI�EN'1' FOR OWNER � <br /> CITY QF ZBPIiXRHTLLS BIIILDING DEPART�7.' <br /> I, ��V`%�``�_—. hav+� read and full�► umderstaad aad <br /> agxee �a th� xovi�ions of this iastrumeat. <br /> The uadersigaed states aad affirms that he ar she is de�sixous of caastructing, <br /> reaovating, addiag to or reroofiag hie or her owss domicile, that he or she <br /> aetua2ly ocaupies, or vail2 accugy by said domicile, aad ssme is aot for <br /> zeat, lease or s�Ze. Tha� he or she sh�ll comp2y with the follawiag coaditiaus: <br /> 1. Tha� �he owner aad ]�e or she alon� sha11 act as the bnilder for all phases of <br /> coa�truction. <br /> 2. That the owa�r will comply with all provis3.oas af the Ci�y of Zephyrhille <br /> ordiaaaces and cades pertiaent to the bu3.Idiag. <br /> 3. Tha� ia the eveat various phases af coas�rs�eticm are subcontsac�ed, he wi1.I <br /> eagage oalg pxapexly licensed subcantractors aad will persoaal.ly supervise <br /> such work. <br /> 4. Tha� im the eveat t}�e 8u31diag Zaspector sha11 xequixe correc�ioas ta be made, <br /> the owaer will aeeume full respoasibility to 3neure they are made, aad upan <br /> aciapletion ,s�ill ca2l far a reiaspection before proceediag with the building. <br /> 5. That the ov�ex sha].1 assvme fu31 responsibility far �he constructioa aad will <br /> aat �xpect sugexvisioa of his work from the C�.ty of Zephyrhill.� Buildiag <br /> Departmeat. <br /> 6. That prior to fia�,l iaepectioa aay add"itional feea, iacludiag seiaspection <br /> fees, :nust be paid ia full. X writtea requea� fxom this office shall <br /> caastitu�e aa offiei.al not3ae ta pay additicnal f��s. <br /> 7. That the owaer sha11 comply with a1Z City, Stat� as►d Fec�exal lavas ia re�ard to <br /> sacial security, workman's compensation, lien laws, etc. , whete applicable. <br /> 8. That the awaer shall comply taith a11 the safety codes i�sued by the Florida <br /> Sadustria2 CammiB�ion. <br /> 9. 3tate law requi.re� constructiaza tc be daae by liceased contractors. You have <br /> apgl�.ed for a permit uader aa �aremptioa to that law. The eacempt3.on allcws <br /> you, aB the owner af your Qroper�y, to �ct as your o�,aa coatractox saith certaia <br /> restric�ioas evea thaugh you do aot� have � license. You must provide direct <br /> onei�e supervisiaa of the coastructioa your�el�. You may 'builc� or improve a <br /> one-�ami2y ar twa-�amily resideace or a f�sm outbuildiag. You may also build <br /> or improve a eomueercial buildiag: provio�ed your costs do not exceed $75,000. <br /> The buildiag or reeidence muet be for your owa use or occupancy. _� may aot <br /> be built ar substasxtially impraved for sale or lease. Zf you sell or lesee a <br /> buildiag you have built or subataat3ally improved youreelf w3thia 1 yesr after <br /> the eonstz�ctioa is camp2ete, �he la�v will presvme �hat yoja built ox <br /> substaatially 3mpraved 3f tor sale ar lease, whieh is �. violatioa of this <br /> �x�mptioa. You may aot hixe atx ualiceas�ed peraoa to act as yoiar coatsaator ax <br /> to supervise people wor-kiag aa your buildixig. It is your respoasibility to <br /> make �sure that people employed by yau have licenses required by s�ate 1aw and ' <br /> by couaty or mvaicipal lia�asing ordinances. Yau may aot delegate the <br /> resgoansibi�.itgr far supervising wark to a liceased eontractor �vha i.s aot i <br /> liceased �o peacfcxm the work being doue. Aay persca �orkia+g on your buildiag <br /> wha is ao� liceaeed musti wark under your direct superv3s3.oa aad mnst b� ' <br /> employed by you, wh3ch meaas that yau must deduct F.I.C.A. aad withhol�iag taac <br /> and pacavide warkers' eamgensation for that employee, all as prescribed by Iaw. <br /> Your canstrvctiau must eomply svith a3I. apPlicable laws, ordiaaaaes, buildiag <br /> codes, and zoni.ag regulatioae. , , <br /> OWNER�S SIGNAfitTRE ' �--�"— � DATE ?J�I tP(I7 I <br /> Ann�ss '� � <br /> P�or�s "�;c'� �c�a. 0'3 �� <br /> Tn1ITPTSSS PS,RHIIT # l <br /> ! � <br /> � <br /> , I <br /> � <br />