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A E i DISCLOSURE STATEMENT FOR Ot+�NER � " � CITY OF 2EPHYRHILLS BUILDING DEPARTMENT 2, have read and fully un.ders�aad aad agree to the grovisions of this iastrument. , , The undersigaed atates and affirms �hat he ar she is desiraus of coastructiag, ; res►ovatiag, adding to or reroqfing his ar hex own domicile, that he or she � actually occupie�, or will occupy by said d'amicile, and same is na� for � reat, I.ease or sale. That he or she shall comply �+rith the fallowing couditions: i 1. That the owaer and he or she alane shall act as �he builder for all phas�+s of i canstructioa. � 2. That the owner will camply with all provisions of the City of Zephyrhill.s i ordinances and cades pertiaeat to the building. � 3. Tha� in the event various phases o� coastruc�ioa are subcoatracted, he will � eagage only properly 2icensed subcoatractors and will persaaally supervise � such work. F 4. Tha� in the even� the Building Inspector sha11 require correctioas �o be made, � the ownez wi21 assume full responsibili�y to insure they are made, and upoa i completa.on wi11 call for a reiaspec�ioa before praceeding with the buildiag. 5. Tha� the owaer shall assume full respousibility for the constructioas and will ; aot expect supervisioa of his work from the City of Zephyrhills Buildiag Departmexlt. 6. That prior to fiaal inspection any additional fees, iucludiag reiaspection fees, must be paid ia full.. A writ�en request from this office shall caastitute au officiaZ notice �o pay adda.tioaal fees. 7. That the owaer shall aomply wi�h al]. Ci�y, S�ate and Federal laws iu regard �o I social security; workman's compensata.on, lien laws, eta. , where applicable. � 8. That the owaer shall comply wi�h all the saEety codes issued by the Florida � Industra.al Cammissioa. ' 9. State law rec;uires constructioa to be done by Iiaensed coatraetors. You hava applied for a permit under aa exemption to that law. The exemption. allows you, as the owaer of your property, to act aa your owa aontraet�or with certaia restric�ions even though yau do not have a 13.cense. You must provide direct oasite supervisiaa o£ the coas�ructioa yaurself. You may build or improve a one-family or two-family resideace or a farm autlauilda.ag. Yau may also build ' or a,mprave a commercial bv.a.lding, provided yaur costs do aot exceed $75,Q00. The buiZding or resideace must be far yaur owrza use ar oecupancy. It may aat ' be buil� or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved gourself within 1 year after � the constructioa is complete, �he law will presurne that you built or substantially improved if for sale or lease, whiah is a vialatioa af th3.s I �emptioa. You may aot hire aa ua.licensed persaa ta act as Iraur coatrac�or ar � to supervise people warkiag oa your buildiag. It is your respaasibility to � make sure that people emplayed by yon have liceases required by state law aad by count�y or municipaZ licensiag ordinaaces. You may uot delegate the responsibility far supervising work to a licensed coatractor who is not licensed to perfarm the work being dane. Any person working oa your building wha is aot licensed must work uader your direct supervisiaa and mus� be employed by you, whieh meaas that gou must deduet F.I.C.A. and withholdiug ta�c and provide workers' compensation far that employee, all as prescribed by law. � Youx con.structioa must comply w' h all ap�licable laws, ordiaa�,ces, buildiag I codes, and zoaiag re lat' s. 04+TNER`S SIGNATURE DP.TE �V U ADDRESS . L �j�s7�/ i PHONE PIITNESS PERMIT # r