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' ' ' ' DISCLOSIIRS STATII�NT FOR OWt�TE�R CITY OF ZEPHYRHILLS BUILDING DFPARTMENT I, 1 �c�,f� /:C.l.l � I J"'e� have read and fully understand and agree to the provisions of this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, addiag to or reroofiag his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is aot for rent, lease or sale. That he or she shall comply with the followiag coaditions: 1. That the owner and 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 ordinances and codes pertinent to the buildiag. 3. That in the eveat various phases of coastruction are subcontracted, he will engage oaly properly liceased subcontractors aad will persoaally supervise such work. 4. That ia the event the Buildiag Inspector shall require corrections to be made, the owaer will assume full responsibility to insure they are made, aad upoa completioa will call for a reiaspection before proceeding with the buildiag. 5. That the owner shall assume full responsibility for the construction and will aot expect supervisioa of his work from the City of Zephyrhills Building Department. 6. That prior to fiaal iaspectioa any additional fees, iacluding reiaspection fees, must be paid ia full. A written request from this office shall constitute aa. official aotice to pay additional fees. 7. That the owaer 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 Iadustrial Commissioa. 9. State law requires coastruction to be doae by. licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions evea though you do aot have a license. You must provide direct onsite supervisioa of the coastructioa 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 building, provided your costs do aot exceed $75,000. The building or residence must be for your own use or occupaucy. It may not be built or substantially improved for sale or lease. If you sell or lease a buildiag you have built or subataatially improved yourself withia 1 year after the coastruction 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 not hire aa unliceased persoa to act as your coatractor or to supervise people working on your buildiag. It is your responsibility to make sure that people employed by you have liceases required by state law and by couaty or municipal licensiag ordiaaaces. You may aot delegate the respoasibility for supervisiag work to a licensed contractor who is not licensed to perform the work beiag done. Any person workiag on your building who is not licensed must work under your direct supervisioa 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 coastruction must comply with all applicable laws, ordiaaaces, buildiag codes, aad zoaiag regulations. OWNER'S SIGNATURE _ / )LNl/!�-� DATE oc� � �� ADDRSSS ��dZ.I '?� ��D PHONE WITNESS PFsRMIT #