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� , DISCLOSIIRE ST�xII�NT FOR OWNER , Cl2'Y OF ZSPIiXRHILL$ SUILDING DBP.ART�I�iT I, [xC�i / ��/�� have read aad fully uadlerstaad aad agre� �o the provisioas af this instrument. The uadersigned etates aad� affirms tha� h� or she is deeiroue of constructiag, reaovatiag: addi.ng ta or reraofia� his ar her av�a damieile, that he or sh� actually accagies, or will occupg hg said damiaile, anci same 3s nat for reat, 1eas� ot sale. Tha�t he or she shall oompl�r �s�vi�h the followir�g aoanditioas: S. That the owaer aud he ox she aloae shall act a� the builder for all phases of coastructioa. ` 2, That the owuer will eamply� w3th �ll. provisicas of the City a� Zephyrhills ordinances �ud codes pertineat ta th� buildiag. 3. That ia the eveat various phases of caastructiaa ax�e subaoatraeted, he will. _ eag�age oaly proper].y liceased subco�ntxactor� aad will persanally �aupexwise guch waark. 4. That in the eveat the Buildirig Iaspector shall require carreatians to be made, �he o+c,r�er wi11 assume full respoasibi2ity to iasure they are mad�, aa.d upon completion w311 call for a reiaspection b�fore p=oceedzng with the building. 5. That th� owraer shall assume £ull reepaasibility for the coastruct3on aud wi11 not expect supervision af his work �ram the City of Z�playrrhills Suildiag Departmeat. 6. That przcr ta �iaal iaspectiau asay add[itianal feea, iacludiag reinspectiaa feesj mu�t be paid in full. A wr3t�eu reqtxe�t from thi� office sha31 coastitute an official not3,ce to gay add3tioaal fees. 7. That �h� owaer shall comply with �11 City, S�ate sad Federa.l laws ia regard to soci.al secura.ty, workman's comp�nsatian, lien laws, etc. , where applicable. 8. That �he oc+*aer shall camply with alI th� saf�ty cades issued by the Florida Iadus�rial Cammission. 9. State law requires coaatxuctioa to be doae by liceased cantractors. You have applied fox a permit u.nder aa exemptio�n to thst lava. The exemQtioa �llow� you. �e the avaaer of your property, to aat as your osva caatractar with cert�ia res�rictioas evea though yau do aot have � license. Yau must psovide direc� ons3te supervisiou of the construatioa yourseZf. You may build or impzav� a one-fam3.ly or t�o-familg residenee or �. farm ou�buildisig. You mag �.lsa build or 3mprove a commercial buildiag, pravided your casts do aot exaeed $75,OQ0. The buildiag or resideace must be �or your owa use or occupaacy. It may aot be built or substaatially improved for sale or lease. I£ yau aell or lea�e a buil�iag you have built or substaatially 3mproved yoursel� withia 1 yea= after the coastr�setiosa is comp].et�, the law va�ill presume that yau built or subatantially improved if far sale ox lea,se, which is a violatioa of this escemptioa. You may aot hire an ualicesased pessoa to act as your caatxaatar or ta sup�errrise people workiag on yaur buildiag. It is yaur r�sponsibility to make sure that p�ople employed by yo�a have licenses required by stat� law and by eauaty or muaicipai lieeasiag ordinaaees. You may nat delegat� ,the respoaaibility for supervisiaq wark to � liaeased coatractor who is' aot liceased ta per�orm the work beiag done. Aay persoa warkia� oa your buildiag who is aat lioens�d must work un.der your direct eugervisioa aad must be -- employ+ed by__You._ which m��aae—tha�vou-must-de�uct-i�.-��.-�: -aad-�ithho-1�3ing--tax— —_--- -_ �`� and provi.de workess' eampensation far that employee, a21 as prescribed by law. Your coastructioa must compZy with al.l appli,cable Zaws, crd3aaaces, buildiug codes, and zoniag r atioa OWNER'S SIGZdAT DATE � �r o�� I ADDRESS �- t r r . t,. 3 � PIiQNT - - 1� AIITNSSS PSRMIT # �