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DISCLOSURE STATEMENT OR OWNER CITY OF ZEPHYRHILLS BUILDX- G DEPARTMENT X, YA, hav read and fully understand and agree t� the provisions of this instrument. The undersigned states and affirms that he or sh is desirous of constructing, renovating, adding to or reroofing his or her o domicile, that he or she actually occupies, or will occupy by a id domicile, and same is not for rent, lease or sale. That he or she shall compl with the following conditions: 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 provision of the City of Zephyrhills_ ordinances and codes pertinent. to the buildin 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors d will personally supervise such work. 4. That in the event the Building Inspector shal require corrections to be made, the owner will assume full responsibility to nsure they are made, and upon completion will call for a reinspecti,on befor proceeding with the building. i, 5. That the owner shall assume full responsibily for the construction and will not expect supervision of his work from-the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written reques� from this office shall 'Constitute an official notice to pay addition 1 fees. 7. That the owner shall comply with all City, St to and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. S. That the owner shall comply with all the safe y codes issued by the Florida industrial Commission. 9. State law requires construction to be done by- licensed contractors. You have applied for a permit under an exemption to th t law. The exemption allows you, as the owner of your property, to act as our own contractor with certain restrictions even though you do not have a lie. nse. You must provide direct onsite supervision of the construction yourself. You may build orb; improve a one-family or two-family residence or a farm o tbuilding. You may also build or improve a commercial building, provided you costs do not exceed $75,000. The building or residence must be for your own use or occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within 1 year after the construction is complete, the law will presume that you built or substantially improved if for sale or lease, +ch is a violation of this exemption. You may not hire an unlicensed per on to act as your contractor or to supervise people working on your building. It is your responsibility to make surethat people employed by you have lic nses required by state law and by county or municipal licensing ordinances. ou may not delegate the responsibility for supervising work to a licen ed contractor who is not licensed to perform the work being done. Any erson working on your building who is not licensed must work under your direc supervision and must be employed by you, which means that you must ded ct F.I.C.A. and withholding tax and provide workers' compensation for that emp oyee, all an prescribed by law. Your construction must comply with all applic le laws, ordinances, building codes, and zoning regulations. ('\ i OWNER'S SIGNATURE DATE ADDRESS ,3QJ0(, -70 a0__tjJ.(7Q_ PHONE C/-A & /ej S-VO 3- WITNES PERMIT #