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; 5 DISCLOSUR$ STATffi��NT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DFsPARTMENT 2, have read aad fully understand and agree to the provisioas of this iastrumeat. The undersigned states and affirms that he or she is desirous of constructiag, reaovatiag, adding to or reroofiag his or her own domicile, that he or she actually occupies, or will occupy by said domicile, aad same is not for rent, lease or sale. That he or she shall comply with the following conditions: 1. That the owaer and 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 ordinaaces aad codes pertiaent to the building. 3. That ia the eveat various phases of coastruction are subcoatracted, he will engage oaly properly liceased subcontractors and will personally supervise such work. 4. That ia the eveat the Building Iaspector shall require corrections to be made, the owaer will assume full respoasibility to insure they are made, and upoa completioa will call for a reiaspection before proceeding with the buildiag. 5. That the owner shall assume full responsibility for the coastruction and will not expect supervision of his work from the City of Zephyrhills Buildiag Department. 6. That prior to final inspection any additioaal fees, iacluding reiaspection , fees, must be paid in full. A written request from this office shall constitute an official aotice to pay additioaal fees. 7. That the owner shall comply with all City, State and Federal laws ia 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 done by licensed contractors. You have applied for a permit under an exemptioa to that law. The exemptioa allows you, as the owner of your property, to act as your owa contractor with certaia restrictions evea though you do not have a license. You must provide direct li onsite supervisioa of the constructioa yourself. You may build or improve a � oae-family or two-family resideace or a farm outbuildiag. You may also build or improve a commercial building, provided your costs do aot exceed $75,000. The buildiag or resideace must be for your owa. use or occupaacy. It may aot be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within 1 year after ' the coastructioa is complete, the law will presume that you built or substantially improved if for sale or lease, which is a violation of this exemptioa. You may not hire an unliceased person to act as your contractor or to supervise people workiag on your building. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensiag ordiaances. You may not delegate the responsibility for supervising work to a licensed coatractor who is aot licensed to perform the work being doae. Aay persoa workiag on your building �� who is aot licensed must work uader your direct supervision and must be li employed by you, which means you must duct F.I.C.A. aad withholdiag tax I and provide workers' com sat' n f at e ee, all as prescribed by law. Your coastructioa mus comp wit all a 'c le laws, ordiaances, building codes, aad zoaing r ula 'oas. OWNER'S SIGNATURE DATE �� ADDRESS p� �f /� PHONE �`� �6� f_l G � 7 WITNESS PERMIT #