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.. � . . , � DISCLOSIIRFs STATEi1�2�1T FOR OT9N8R CITY OF ZLPHYRHILLS BQILDINffz DEPARTI�PTT � � I, have zead aad fuliy understand and I agre� �o the pravisions of this iast�rumeat. The uader�igaed states aad affirms that he or she 3s desirous of caaetructing, reaovatiag, adding ta or reroo�iug his or h�r own domicile, that he or she actually aecupies, or will acaupy by said dom3.cile, sad s�►t� 3.s aot �or reat, lease ax sale. That he or she shall camply with the followiag conditiane: I 1. That the owmer aad he or ehe aloae shall act ae the buildear far all phases of � coastruation. � 2. That the awaer w31Z comply with all psova.sioas of the City oE Z�phyrhills ardin�aees aad cades pertiaeat to the buildiag. 3. That ia the even� various phases of cas�..�truction are subeoatracted, he will eugage only properly liceasec� svbcoatx�ctoxs aad vri13 persaaall�r stapervise such work. 4. That iu the ev�at the Suildiag Iaspector shall require correctiaas to be made, the oivner wil3 assume full respoasibil3.ty to insure they are made, aad upcn eompZetiaa vrill e�31 for a reiaspeetioa b�fcre proaeediag �vith the buiidiag. S. Tha� the owaex sha].1 aesume full resposxsa.bility far the coastzuction aad vai22 aot e�eot aupetv3sion of his vaark £rom �he C3t�► af Zephyrhills Suildiag � Departmeat. 6. Tha� psior ta fiaal inapectiou aay additioaal feea, includiag refaspectioa fees, must be p�id ia �ull. 1i writtea r�quest �rom this of£ice sha11. coastitu�e au o�fics.al aotiae to pay additiaa�l fees. 7. That the owa�r shall comply with a11 C3ty, State aad Federal 2aars i.a regard to sacial security, workman�s aompensation, lien laws, etc. , where applicable. 8. That the owaer shall comply with a11 the safety codes issued by �he Florida Iadusttial Cammissica. 9. State law requires construetiaa to be done by 2iceased coatractors. You have appl3ed for a permit uadex aa �as�mpti.oa ta that law. The e�cemgti.an a2Zoces you, sa the ova�n�r of yaur property, to aact �s y►our owr� cozttractor w3th certaia resstrictions evea though you do sio� h�ve a l.iceaee. You must provide direct onsite supez-v3sioa of the caastruc�iaa your�el�. You may bufld or 3.mprove a oae-f�m3,lg or two-family resideace or a f�.rm outbuilding. You may also build or 3mprav� a commexcial buildiag, pravided gouz casts do aot e3tceed $75,000. The buildiag ar resideace must be £or yaur owa uee or aceupaacy. I� may not be built or aubsta�ntially imapraved for �sale or lesee. If you sell or lease a bui3ctiag yau �ave built or subBtaatially impsovet� ycuzself withfa 1 y�ar aFtez '� the coastructioa is cample�e, �he Iaw �ill presume that you built or �, anbst�.atially improve� if foz sale ar le�se, which �.s a violatioa o� this exemption. You magr aot hixe aai ualfcensed p�raoa to �ct as yaur aaatsaatas ar to supexvise people workiag oa your b�sildiag. It is your respoasibility to make sur� that people em�ploy�d by yau have liceases r�quired by stat� �la�ior aad by ccuaty or mua�.cipal liaeasiag ordtivances. You may aot deleg�te the xespo�nsibility fdr supervisiag wark ta a l.icensed contraatar wha is aot liceased to perfaxa► the work being doae. Any persan workiag an your bui2ding who is aot la.c�ased must war}e under your direct svipervia3on aad meast be ------- _. e�l�ed_byyouuL�vl3�.ch_.�teaxxe_that_.��v...mu�t-d�du,�G-g:�:C-:�r:--ead�svit-3nc�s3-dingt�c_.__.___ ._ ---- ---- and provide ieor3cers' compensation far that emp2oyee, alI aB prescribed by law. � Your constaeuatioa mus� comply with a13 app3icable laws, ordinaaces, buildiag ' codes, and zaniag regulations. ��"--y-,---�--,-;�� _�..-r_,��,�, ._..,� OT+dt3ER'S SIGNAfiURE=--;-t"-tC�,.`�7,rn.\Y'LCl �i�itmt'�CY'1C��, �A'PE=�� -"�v`{-�,-��_ ' .�F.:3A.�.'�T»S�,^��,dL i�"� Q / ADDRBSS � I3�QNB��'�a 2�_`�- � �� 3� iATTNIBSS PSi2Id.TT # � , ; :