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�ISCLOSURE STATEt�RTT FOR O�PTER CITY OF ZSPHYRHILLS H'�ILD2NG DEPARTP' �PlT I, �..� (,..,�--5 have zead and Eully uaderstand and agree �o th�e grcvisions o€ th3.s inst�unent. The undersigaed states aad affirms that� he or she 3s desirous o€ conatructiag, reaovatiag, add3ag �o ar retoofiag h3.s or her owa domicile, that he ar she actually oeaupies, or wil.l occupy by 8sid domicile, �nd same is aot for teaat, lease as sale. That he or she sh�ll cam,kssly with the followiag coaditions: i. That the owaer aud he or she a1oa� shall act a� the bniZder �or a1]. phases of coastacuction. � 2. That the owner will campZy w3.th a13 pxovisioa� of the City of Zephyrhille ordiasaces and cades pertiaeat to the bua.ldiag. 3. That ia the event variaus phases of aozastruction ar� subcantraated, he wi11 eagage oaly properl� licease�. subcontractors aad will pezsoaaliy aupervise auch work. �4. Tliat ia the eveat the �uildiag In�pector s]sa11 require correc�ioas to be made, the owner will assvme full reeponeibility to iaeure they are saade, and upon aomp3etion wi21 ca22 for a reiaspectioa before praceediag with �he buildiag. 5. Tha� bhe otdaer shall assume fuZl respo�nsibility far the coastzuctioa aad wi1l I aot expeat supe�nrisioa of his wark Erom the Citgr af Sephyrhsils SuiZding Departmeut. � 6. R'hat prior to fiaal inepectioa aay add'3.tioaal feeB, iacluditig reiaspection fe�s, me�st be paid iu fu3.1. �i. written z�quest from thie office sh�l]. '� coa�t3tute aa off3.cial notice to pay adciitiaaal .fees. � 7. That the owaer shall comply w3th all City, State aad Federal laws #.a regaxd ta social security, workman�s comp�nsatzon, lien l�ws, etc. , where applicable. 8. That the owaer sh�Il camply wi.th all the sa�ety codes iss�ted by the Floric�a Iadustrial Comma.ssioa. 9. State law xec�,uires coastsuetica ta be doae 2�y liceztsed coatractors. You have applied for a permit uader aa exemgt3.aa to that law. The �acempt3.an a2loivs you, as the owner of yaur property, to act as your owa coatractor with aertaia restriations evea thaugh you do ao� ]��ve a license. Xou must pravide direct oaeite supervi.sian cf the canetruc�iaa yourseZf. You may build or imprave a one-f�m3,ly or t�o-faatily re�id�nce oz a f�.rm outbuilding. You may �iso build or improve a Gommexcial buildiag, proRric��d your costs do aot exeee� $75,000. I The buildiac� or reeideace must be for yous owa ua�e or oceupaney. Iit may aat be built or substant3ally impraved fo�c aale or lease. If you sell or l�ase a buildiag you havre built or sube�taati�lly 3mprovedl yoursel£ withia 1 ye�r after th� canstructioa is compZata, 1�he I�w �e3.I1 presume that you built or , substaatially improved if tor sale ar 2e�se, which is a vialatioa o� this exemptioa. You may aot hixe � ualic�aset� person to act �.s your ccntraator oz to superv3s� people workiag oa your buildiag. It i� your respon�3.bility to ��, make suse that people employed by yau have liceases required by sbat� law and � by coxaaty ar mvafcipa2 liceasiag ordivan,cea. You may aot delegate �he respansib�.lity for sup�rvi�ing work tc a liaensed aa�traatar who is aot liceased to perform the woark beiag doa�. Aay person warkiag an your bui2c�iag who is aot liceased muet work under your di,rect aupervisiou aad must b� -------- -�l�ed_byyouu� wl3�r��►e�ns_that_�►n++ must-deda��-R.-,�:+��--ead-�ithhciding tax-- ----- -- -- -- ' and provid� �aorkers' compensation far that employee, alI as pacescr3bed by laiv. Yonr constructioa mus� aompZy with aI3 appZicabl� laws, osdiaaaces, buiidiag � cocles, aad zoaiag re Gions. � OWNER'S SI6NATURE l��Q�j DATE � 1�iDDRESS �" PHON'E WITNSSS PSRY6ST #� � , ; L. _