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w' <br /> DISCLOSURE STATEMENT FOR OWNER <br /> ' CITY OF ZEPHYRHILLS—BUYLDING DEPARTMENT <br /> / have read and fully understand and agree to the <br /> provisions of this instrument. <br /> The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or <br /> reroofing his or her own domicile, that he or she actually occupies, or will occupy by said <br /> dmmio||e, and same is not for rant' lease or sale. That he or she shall comply with the foUmvvng <br /> conditions: <br /> 1. That the owner and hmmr she alone shall act om the builder for all phases of construction. <br /> 2. That the owner will comply with all provisions of the City nf ZephvrhiOm ordinances and codes <br /> pertinent bmthe building. <br /> 3. That in the event various phases of construction are aubomntnanted, he �ill engage only <br /> properly licensed subcontractors and will personally supervise such work. - <br /> 4. That in the event the Building Inspector shall require corrections to be mnode, the owner will <br /> 000uma full responsibility to insure they are nmade, and upon completion will moU for a <br /> nainspeobon before proceeding withthe building. <br /> 5. That the owner shall assume full responsibility for the construction and will not expect <br /> . supervision of his work from the City ofZaphyrhiUs Building Department. <br /> 6. That prior to final inspection any additional fees, including reinspectlon fees, must be paid in <br /> full. &written request from this offioeshall constitute on official notice to pay additional fees. <br /> 7' ThotthecxmDermhaUomrnmlyvxithoUCitv, StadeondFedmral |enxsinrmgardboeomia| oacuritv. <br /> xvorkrnon'mcompensation, lien laws, mdc,where applicable. <br /> 8. That the owner shall comply with all the safety codes issued by the Florida Industrial <br /> Commission. <br /> 9. State law uires construction to be done by licensed contractors. You have applied for a <br /> permit underan exemption to that |umx The exemption sd|mws you, as the owner of your <br /> property' to act as your own contractor with certain restrictions even though you do not have <br /> m |icenoe. Youmust"provide direct mnniha supervision mf the construction yourself. You may <br /> build or improve one-family two-family residence or a farm outbuilding. You may also <br /> build or improve a commercial building, provided your costs do not exceed $75,000. The <br /> buildin <br /> or residence must be for <br /> own use or <br /> ancy. It <br /> built or <br /> substantially . � roved if for | lease,- which isviolation'oft `s exemption. <br /> � may not <br /> hire an drill cens I ed person to act as your contractor or to supervise people working on your <br /> building. ,lt'Js,.y9ur responsibility to make sure that people employed by you have licenses <br /> required b�`,�fate law and by county or municipal licensing ordinances. You may not delegate <br /> the responsibility for SUDervising work to a licensed contractor who is not licensed to perform <br /> the work being done. Any person working on your building who is not licensed must work <br /> under your direct supervision and must be employed by you, which means that you must <br /> deduct F.I.C.A. and withholding tax and provide worker's compensation for that employee, all <br /> as prescribed by law. Your construction must comply with all applicable laws, ordinances, <br /> building codes, and zoning regulations. <br /> OWNER'S SIGNATURE = ^� <br /> ADDRESS 335ye <br /> PHONE <br /> WITNESS PERMIT <br />