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� � DISCLOSUR� STAT�MENT FOR OWN�R CITY OF ZEPHYRHILLS BIIILDING D$PARTMENT / . 2, f,il/�1� � I�C,J�� have read and fully uaderstand and � agree to the provisioas of this iastrument. The undersigaed states and affirms that he or she is desirous of constructiag, reaovating, addiag to or reroofiag his or her own domicile, that he or she actually occupies, or will occupy by �aid domicile, aad same is not for rent, lease or sale. That he or she shall comply with the followiag coaditions: 1. That the owner aad he or she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordiaances and codes pertinent to the buildiag. 3. That in the eveat various phases of constructioa are subcontracted, he will � engage oaly properly liceased subcontractors and will personally supervise such work. 4. That ia the eveat the Buildiag Iaspector shall require correctioas to be made, the owaer will assume full respoasibility to iasure they are made, aad upon completioa will call for a reiaspection before proceediag with the buildiag. 5. That the owner shall assume full responsibility for the constructioa aad will aot expect supervision of his work from the City of Zephyrhills Buildiag Department. 6. That prior to fiaal inspectioa any additional fees, includiag reiaspectioa fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owaer shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires constructioa to be doae by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owaer of your property, to act as your owa contractor with certain restrictions even though you do aot have a licease. You must provide direct oasite supervisioa of the constructioa yourself. You may build or improve a oae-family or two-family residence or a farm outbuilding. You may also build or improve a commercial buildiag, provided your costs do aot exceed $75,000. The buildiag or resideace must be for your owa use or occupancy. It may aot be built or substantially improved for sale or lease. If you sell or lease a buildiag you have built or substaatially improved yourself within 1 year after ' the construction is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violatioa of this exemptioa. You may aot hire an unliceased persoa to act as your coatractor or to supervise people working on your building. It is your responsibility to make sure that people employed by you have liceases required by state law and , by county or municipal licensing ordinances. You may not delegate the i respoasibility for supervisiag work to a liceased coatractor who is aot liceased to perform the work being doae. Any persoa workiag on your buildiag who is aot liceased must work vader your direct supervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordigances, building codes, and zoning regula oas. OWNER'S SIGN�tATURE ' �2 DATE , ADD S `t � HONE �9/ Q i' J_ �T[�'—W-T—�� - WITNESS PERMIT # / 1. � �� {J � /c/✓��Id� � /' " � , ��-��r "� Y / 7"�lpG w.c�� I