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� ' � I3ISCLOSIIRE STATEE�NT FOR QWNER CITY OF' ZLPHYRIiILLS BIIILDING DEPARTP�NT _. '" d s� ��"�� hav� read aad fu21y uaderstaad aad agree to the provisiona of this instrumeat. T3se unders3,gaed sta�es aad affirms that he or she is desiroue of canstructiug, renovatiug, adding t�o ar reroofiag his o h r own domicile, that he or she actually occupies, ar wi13 oecupy by �� said domicil�. and same is aot far reat, lease or sale. That he or she shall compZy wi�h th� fallawiag eonditions: I'. That the owaer aad he os eh� aloae shall act as the builder for all phaaes of coastruction. 2. That the owiter will ccmply �vith all provisiaas of the City of Zephyrh311s ardin�aces and codes pertineat to the buildiag. 3. That in the event various phases of conetruction �re subcontracted, h� will engage anly prop�rly licensec� subcoutractars aad wi11 p�arsonally supezvise such work. 4. That ia the eveat th� Buildiag Iaspector shall require correctioas to be ma�de, �he owaer will assvme fu13. r�sponsibi2ity ta iasure tSey are made, and upon complet3on will ca11 for a reiuspection befoze proee�c3iag with the build3.ag. 5. That the otaaer shall assuaae iEull respoasibil3ty for t�e coas�ruction and will not expect supervision af hia work tram th� City af Zephyrhills Suildiag � , Department. _ 6. That pricr to final iaspeatiaa any adc�itioaal fees, incZudiag reiaspection fees, must be paid ia full. A writ�ea request fram this offiee shaZl coa�titute aa afficial notice to pag additfonal fees. 7. That� the owaer shall comply wa.th �11 City, State aad Federal laws ia regard to social security, workman's campensa�ian, lien laws, eta. , sahere applicable. 8. That the o�va�r sh�31 camply with �11 the safety codes issu�d by the Fla=ida '. =adustria]. Commissioa. � , 9. Stat�e law zequires coastruction ta be dosie by 13.e�nse�. eantractars. You ha.ve ' appli�d �or a� permit uader aa exempt�.oa to that law. Th� exempt3on allows you, �� the owaer of your property, to act as your own coatractor s,rith certaia � reStrictions even though you do aot have a licease. Yau must prov3de direct aasite supervision of the eanstruetioa yoursalf. You may builc� or improve a one-f�xnily or t�o-familg residesice or a farm ou�,buildiag. Yau may also build or 3mprove a comm�rcial buildiag, pravided your costs do aot �asceed $75,4QQ. The buildiag or resideuce must be fox your owa use or occupaacy. It may ao� be built or subst�ntially improved far sal� or lease. Tf you sell or leaee a buildiag you have built ar svbs�satially improved yoursel� withian 1 year after the aoastruction is complete, the law vaill pr�swme that you built or substaata.ally impxoved i£ for sale or le�se, t,rhich is a vs.olation of this exempti.oa. You may mot� hire sa ualiceased pezsoa to act as your coatr�atax or ta supervise people workiag oa your bu3lding. It ie your responsibility to m�.ke sure that p�aple �mp2ayed by you ha�re licenses r�quired by stat� law aad by couaty ar mun.icspal 2iceasing ozdiaaaces. You may aot de3egate the r�apoasibility for supervisiag rvork ta � liceased caatractor taho is aot liceased to per£orm th� work b�eiag done. Any persoa warkiag oa your buil8iag who is aot licens�d must �ork uader your direct supervisiaa sad must be —�__�loy�d byyouu�v�rhicb m�aas—tha.t_�rau--must-deduct-1�.�.-C-.-3i��aad-withho3-ding--taxv-------_i and grovide work.ers' eompensation fcx that employee, aZl as prescribed by 2aw. � Your can�tx�otiaa must aomply with a12 applicable laws, ardiaaaces, bui2diag codes, and zoaiag regul�tions. � 06�1i3ER`S STGNATT[3RE � ' DATE � l� ��' 1aiDDR833 fP2�" /`� /� 3S-��,`� pxorr� ��—�5--� �� ' , wz�ss PSRPPBIIT #