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_ DISCLOSURE STATffi�NT FOR OWNFR CITY OF ZSPHYRH � ILLS BUILDING DFPARTMENT B ' _, ' have read and fully understand and agree to the provisioas of this iastrument. The undersigned states and affirms that he or she is desirous of constructing, reaovating, adding to or reroofiag his or her own domicile, that he or she actually occupies, or�will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following conditions: I . l. That the owaer and he or she aloae shall act as the builder for all phases of ' construction. 2. That the owner will comply with all provisions of the City of Zephyrhills ' ordinances and codes pertineat to the building. 3. That in the eveat various phases of constructiou are subcontracted, he will �I engage only properly licensed subcontractors aad will personally supervise such work. 4. That in the event the Buildiag Iaspector shall require correctioas to be made, the owaer will assume full responsibility to iasure they are made, and upoa completion will call for a reiaspection before proceeding with the building. 5. That the owner shall assume full responsibility for the construction and will aot expect supervision of his work from the City of Zephyrhills Building I Department. 6. That prior to final iaspection any additioaal fees, iacludiag reiaspectioa fees, must be paid in full. A writtea 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 in 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 Commission. 9. State law requires construction to be done by liceased contractors. You have applied for a permit uader an exemptioa to that law. The exemptioa allows you, as the owner of your property, to act as your own, contractor with certaia restrictions evea though you do not have a license. You must provide direct onsite supervision of the coastructioa yourself. You may build or improve a one-family or two-family residence or a farm outbuildiag. You may also build I� or improve a commercial buildiag, provided your costs do not exceed $75,000. The buildiag or residence must be for your own use or occupancy. It may not I� be built or substaatially improved for sale or lease. If you sell or lease a buildiag you have built or substantially improved yourself within 1 year after the constructioa 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 coatractor 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 couaty or municipal licensing ordinances. You may not delegate the � responsibility for supervising work to a liceased coatractor who is aot ' licensed to perform the work being done. Any persoa workiag on your building who is aot licensed must work under your direct supervision and must be � employed by you, which means that you must deduct F.I.C.A. aad withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building � codes, and zoaing regulations OWNER'S SIGNATURE DATE Z J ' ADDRESS PHONS WITNESS PERMIT #