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, DISCLOSURE STATEMENT FOR OWNFR CITY OF ZEPHYRHILLS BUILDING D}3PARTMENT � I, ��Q�el� � �c.v ��✓ have read and fully understand and agree to he provisions of this instrumeat. ' The uadersigned states and affirms that he or she is desirous of constructing, reaovating, addiag to or reroofing his or her owa domicile, that he or she actually occupies, or will occupy by said domicile, and same is aot for reat, lease or sale. That he or she shall comply with the following coaditioas: 1. That the owner and he or she aloae shall act as the builder for all phases of construction. 2. That the owaer will comply with all provisions of the City of Zephyrhills ordinaaces and codes pertiaeat to the buildiag. 3. That ia the eveat various phases of construction are subcontracted, he will engage only properly liceased subcoatractors and will personally supervise such work. 4. That ia the event the Buildiag Iaspector shall require corrections to be made, the owaer will assume full respoasibility to iasure they are made, and upon completion will call for a reinspectioa before proceeding with the buildiag. 5. That the owaer shall assume full respoasibility for the constructioa and will aot expect supervisioa of his work from the City of Zephyrhills Building Departmeat. 6. That prior to final inspection any additioaal fees, iacluding reiaspection fees, must be paid ia full. A writtea request from this office shall coastitute aa official aotice to pay additional fees. 7. That the owaer shall comply with all City, State aad Federal laws ia regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commissioa. , 9. State law requires construction to be doae by liceased coatractors. You have applied for a permit under aa exemptioa to that law. The exemptioa allows you, as the owner of your property, to act as your owa coatractor with certaia restrictions evea though you do aot have a license. You must provide direct onsite supervisioa of the constructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuildiag. You may also build or improve a commercial building, provided your costs do not exceed $75,000. The building or residence must be for your own use or occupancy. It may not 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 coastruction is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violation of this exemption. You may not hire an unliceased person to act as your contractor or to supervise people workiag on your buildiag. It is your respoasibility to make sure that people employed by you have licenses required by state law and by couaty or mun.icipal liceasiag ordinances. You may not delegate the responsibility for supervising work to a liceased contractor who is aot licensed to perform the work being doae. Aay person working oa your buildiag who is aot liceased must work uader your direct supervisioa aad must be employed by you, which meaas that you must deduct F.I.C.A. aad withholdiag tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicabl laws, ordinances, building codes, and zoaiag regulat' �'. OWNER'S SIGNATURE -- DATE /� �/� ADDRESS �n'S�� " dvr i , � % 3,r-L/Z PHONE ��- �S2-3/7/ WITNESS PERMIT #