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tY � � DISCLOSIIRE ST�TEt�NT FOR OWNER CITY dF ZSPHYRFiILLS HIIZLDING D73PARTI+�NT =l have read aacl fu1Sy uaders�and aad agree ta the provisiaas o£ this iastrumeat. The undersigaeci etates and affiaems �hat he or she is desirous af coastructiag, reaovatitxg, addiag ta or reroofiag his ar her owsi. domicile, tha� he ar she actually OCCiIj}7.ES j os wiZ3. oecupy lay sais� domici3.e, and same is not for reat, lease ar sale. That he ar she shall camply with the following conditians: I. That the owaer an.d he ar she alaue shall act as the builder for all phasee of coaetructioa. 2. Tha� the atvaer will comply vaith a3.3 provisicas of the City of �ephyrhille ordiaanc�s aad codes pertineat t�o the bua.ldiag. 3. Th�t ia �he event variotts phases of coas�xuation are subcaatract�d, he will engage oaly propexly licens�d subcoa�rac�ors and will person�lly aupervise auch wor]s. 4. That in �he eveat the Suilding Iuspector shall require aorrectious ta be made, the cwner w.i11 aseume full respaassibility to iasure they are mad�, a�nd upon ctm►pletion wiSl caZl fax a reiaspectioa b�fore proceed3ng w%th the buildiag. 5. That the owaer sha11 assume full respoasibili�y for the construc�ion and will � aot e�ect supervieion of ha.e work fxasn the City 'of Zephyrhi2ls Suilding bepartmeat. 6. Tha� priar to fiaaZ inepectii.oa any additiaaal fees, includiag reiaspectiaa fees, must be paid in �u3.I. A written request fram this affzee sh�21 coas�itut�e an officfal uotiae ta pay �dditiona•1 fees. ?e That the oiaaer sha11 camply �r�th all C�ty, State and Federal Iaws in regard to social seauri�y, warkman's compensation, lien laws, etc. , whete applicable. 8. That the awaer sha11 comply with all �he safety codes issued lby the Floridm Industria�, Commis�ion. 9. State law requires conetructa.oa to be done by liceased contractors. Yau hav� �pplied for a permi� uader aa exemption to tha� la�*. The �emptioa allaws you, as the ow�ser of your properby, to act as your own coatractor with cert�aia restrictioz�.s evea though you do nat have a licease. You must provid� direct � oasite supervisian af the caastructiaa youreeZ�. You may 'bui2d or impxove a oae-Eamily or �wo-iEamily residenc� or � farm outbuildiag. You may alsa bu31d ar improve a comm�sciaZ building, Provided yauz cos�s do aot �sce�d $?5,000. The buildiag or res�ideaae mu�st b� for your owa use or occupaaay. It may aot be built or �ubstantially improved for sale or lease. If you sell or lease � buildiag you have built or substas�tially improved yaurself withia 1 year a£ter �he coastxuctiaa is complete, the 1aw will presume that you built or substaatially 1,ICt�=4"ST�CI if for sale or lease, whieh is a vialatian of th3.s escemp�ioa. You may aot hire �au ualic�ased pereon ta act as your coatractor or �a supervise people worltiag oa your building. st is yaur r�spaas3b�li�y to ' xnmke s�ure that peaple emplo}►ed by you have Iiceases z�quired by s�ate law aad by county or muaicipal 13censiag ordiaaacea, You may aot delegate the responsibility for supex.vising ivark to � licens�d eosxtractor who is no� liceased to pextorm the work beiag done. Aay persoa workiag oa yaur buildiag ', who is aot liceased must work uac3ez yonr d3.rect supervisioa aad must be emp2oyed .by you. wh3.ah meaas that you must cieduct F.T.C.A. aad withholdiag tax and provide �aorkers' compensation for that employee, all as prescribed by l�w. '� Your caastruction must eamply with a3I. app3.icab2e Iaws, asdinaaces, buildiag ! codes, aa8 zoaiag regulations. i • t j j OWNEIt'S SIGNATURE DATE c�i/.2-'�// Ai ADDRESS [°,�i �orrs __�1.3 �.3�'�-�35�� ws�xsss �s�r� # � � i !