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DISCLOSUR.� STATEMENT FOR OWNRR CITY OF ZEPHYRHILLS SIIILDING DEPARTMENT I, have read and fully understand and agree to the provisions of this iastrument. ' The undersigaed states aad affirms that he or she is desirous of constructiag, reaovating, adding to or reroofiag his or her own domicile, that he or she ' actually occupies, or will occupy by said domicile, aad same is aot for reat, lease or sale. That he or she shall comply with the followiag conditions: 1. That the owner aad he or she alone shall act as the builder for all phases of coastruction. 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertiaeat to the building. 3. That ia the event various phases of coastruction are subcontracted, he will eagage only properly liceased subcoatractors and will persoaally supervise such work. 4. That in the event the Building Inspector shall require correctioas to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspectioa before proceediag with the building. 5. That the owner shall assume full respoasibility for the constructioa and will not expect supervision of his work from the City of Zephyxhills Building Departmeat. 6. That prior to final iaspection any additional fees, iacludiag reinspectioa fees, must be paid ia full. A written request from this office shall coastitute an official aotice 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 Iadustrial Commission. 9. State law requires construction to be done by liceased coatractors. 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 own coatractor with certain restrictioas even though you do aot have a license. You must provide direct oasite supervisioa of the coastructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial buildiag, provided your costs do not exceed $75,000. The building or residence must be for your own use or occupaacy. It may not be built or subatantially 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 substaatially improved if for sale or lease, which is a violation of this exemption. You may aot hire an unliceased persoa to act as your contractor or to supervise people working on your buildiag. It is your respoasibility to make sure that people employed by you have liceases required by state law and by county or muuicipal licensing ordinaaces. You may aot delegate the reaponsibility for supervising work to a licensed coatractor who is aot liceused to perform the work beiag done. Aay persoa working oa your building who is aot licensed must work under your direct supervision aad must be employed by you, which means that you must deduct F.I.C.A. and withholdiag tax and provide workers' compensation for that employee, all as prescribed by law. Your constructioa must comply with all applicable laws, ordinaaces, building codes, and zoniag regulations. OWNER'S SIGNATURE � ^ DATE �� `�� ADDRESS 5 T / PHONE 3 S 3 WITNESS PERMIT #