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� - -- � , , ' 33ISCLOSIIRE STATEI�I�T1' FOR OWNER CIfiY OF �BPH;YRkIILLS HIIILDINC DEPART�T _, h�ve zead aad f�.11y understaad aad agree to the provisions of this instsumeat. The uad�rsigned state8 aad affirms that he or she is desirous ot coastructiag, renovatissg, addiag �a ar reroofing hats or 3ier owa domicile, tha� he or she ', actual].� occugies, or wi3.l oeeupy by �aid domicile, aad same is nat for reat, 1eas� or sale. That he ox she shall aomply with th� fa2iowiag eanditiaas: 1. That the owaez aad he os she aloae ehall ac� as the buil.der for all phaseB of car�s�ruction. � 2 s ' That th� oc�aer vs3ll compZy w3th alI provisions of the City of Zephyrhi,Ils ordia�aaes aad cadles pertiaent to the bui2ding. 3. That in the event variou� phaaes of constz�uctiaa are subcontracted, he w3I1 engage anly properly liceaaed subcoatractors a�nd will persaaally supezvise such wosk. 4. That in th� eveat the 8uilditig Iasg�ectox shall require correations to be made, the owaer will aesuiae fu21 responsibility ta iasure they axe made, aad upou completion w311 ca11 fos a reiaxspeetion b�fore groaeeding wi�h the buiiding. 5. That the a�vaer shall assume �ull reepcaeibility for the coastructioa aad vrilZ not expect sup�ervisioa of his work from the City of Zephyrhill:s Suildi�ng Departmeat. - . � � 6. That pr3or to �inal iaspect3oa any additioual fees„�.includ3:ag reiuspectian �ees, must be paid i.n full. A writteat recau�st �rom this offic�� sh�i3. , coasti.tute aa offa.cial aot3c� to pay additional feeo. . ' 7. That t�he awn�r shall comply with �l]. City, State and Fede'ral laws ia regard to soci.al seaurity, saorkman's compen�a�ian, lien laws, etc. , where applicable. 8. That �he awaer shall camply with aIl the sa�f�ty cades isaued by the Flarida Izxdustrial Commission, ' 9. State �.aw reguires constzuction to be doae�liy li'eensed cantractors,.. Yau have applied �or a permit uader aa exemptioa to that law. The exemg�ion allaws you. �s the owaer of your property, to act as your owa coatractar wi�h certain restrictioras even though you s3o aot ha�cre a Iicease. Yau must provide direct ansite supervision of the canstructioa youzse2f. You may build or improve a oae-�a�miZy os tx*o-family resideace ar a faz�ni ou�building. You may aZsa buil� os impsove a commercial building, provided gour costs do aot easceed $75,4QQ. The buildiag. or residence must be for your owa use or occupaacy. St may ao� be built or sub�taatially improved for sa1� oz lease. If yau sell or. lease a bui2dizig yau have bu31t or substaatial3.y improv�d yourself withia 1 yeas �afi�er the constrvtetian is eomplete, the 2aw will presume that you built as 8ubstanta,ally improved if for sale ox lease, 'wlu.ah is a violatioa of this e�cempt3ou. You max aot hire aa unlicensed persaa to act as your coutr�ctor or ta supervise people workiag oa your bu3lc�iag. It is your r�sponsibil�ty to make sure that peaple emplayed by you have liceases requirec� by stat� law aad by county or muaieip�l Iiaeasing ordiaances. You may aat delegat� the respoasibility for augexvising work �a a licensed coatractcr vaho is not liceased to perform the work beiag daae. Aay ,persaa workiag oa your bu3ldiag who is nat liceased mugt work under your direct supervieion aad must be ------ employ�d bv vont�hich..m�,aas_that yeu-must-ded�at�'.-�-.-C-.�r:aad�-witirlsa-l:diag rtax�—_i_______ and provide workers' campensation for that emp3oyee, all as pr�$cribed by law. Your canatructioa must aomply with aZl app33eable laws, ordiaaaees, bui3diag codea, aad zoniag regulat3ons. , . '• .F, � ,. �: OWI�TEER'$ SIGNAfiURE � `�:�`" '' ATE �' ADL?RBSS t PHON� ` —�-- . T�IT1dRSS FSRMIT # .. ; . , j � l