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' � DISCLOSUR� STATEMENT FOR OWPTER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, l'ty��e �,/��,rr.� have read and fully understaad and � agree to the provisions of this iastrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for reat, lease or sale. That he or she shall comply with the following 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 ordiaaaces and codes pertiaent to the buildiag. 3. That ia the event various phases of coastruction are subcoatracted, he will engage only properly liceased subcoatractors and will personally supervise such work. I 4. That ia the eveat the Building Iaspector shall require corrections to be made, the owaer will assume full responsibilit to iasure the are made, and u on Y Y P completion will call for a reinspection before proceeding with the building. 5. That the owaer ahall assume full reaponsibility for the coustructioa and will not expect supervision of his work from the City of Zephyrhills Buildiag Departmeat. 6. That prior to fiaal inspection aay additioaal fees, includiag reiaspectioa fees, must be paid in full. A writtea request from this office shall constitute aa official notice to pay additional 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 Commissioa. 9. State law requires construction to be done by licensed contractors. You have applied for a permit uader an exemptioa to that law. The exemptioa allows you, as the owaer of your property, to act as your owa contractor with certain restrictions evea though you do not have a license. You must provide direct oasite supervisioa of the construction yourself. You may build or improve a oae-family or two-family residence,or a farm outbuildiag. You may also build ' or improve a commercial buildiag, provided your costs do not exceed $75,000. ' The buildiag or resideace must be for your own use or occupaacy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substaatially improved yourself within 1 year after the constructioa is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violatioa of this exemption. You may not hire aa unliceased person to act as your contractor or to supervise people workiag oa 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 liceusing ordiaances. You may not delegate the ' responsibility for supervising work to a liceased contractor who is aot licensed to perform the work being done. Any persoa working on your buildiag who is not liceased must work under your direct supervision and 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 coastruction must comply with all applicable laws, ordinances, building codes, aad zoniag regulatioa . � / OWNER'S SIGNATURE DATE f„Z� � � — I � ADDRESS 3 O y� 'K 'y� � � ' PHONE fjl�-7�y' S�O"G3 ' WITNESS PERMIT # I