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^ . . � DISCLOSURE STATEMENT FOR OWNER CITY OFZEPRYR0H\LLS—BUILDING DEPARTMENT 1, -M t,04 &Cky---N have read and fully understand and agree to the p �i of this instrument. rovis . The undersigned states and affirms that haorshe is desirous of constructing, renovating, adding toor reroofing his or her own domicile,that haor she actually occupies, or will occupy by said domiui|e, and same is not for nerd, lease or sale. That he or she shall comply with the Foil—owing conditions: 1. That the owner and heor she alone shall act as the builder for all phases ofconstruction. 2. That the owner will comply with all provisions of the City ofZephmhiUo ordinances and codes pertinent tothe building. 3. That in the event various phases of construction are mubcontn*ct*d, he will engage only properly licensed subcontractors and will personally supervise such work. 4' That in the event the Building Inspector aheU require corrections to be made, the ovwmerViU ooaunmo full naepmnoibi|ib/ to insure they are made, and upon completion will call for m nainepemtion before proceeding with the building. 5. That the owner ehoU assume full responsibility for the construction and will not expect supervision of his work from the City ofZephyrhiUo Building Department. 6. That prior bofinal inspection any additional fees, including nainmpeoUon#ama. must be paid in full. A written request fromthieofficeoha|| nonmiituhoanofficia| notiootoVayoddiUono|feeo. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, vvorkrnen'acmnnpenao1ion' lien laws, mtc..where applicable. 8. That the owner shall comply with all the msdetv 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 that law. The exemption oUnvms you, as the owner of your property, to act as.your own contractor with certain restrictions even though you do not have ` a |icenoe. You must provide direct onsite supervision of the construction yourself. You may build or improve m one-family or two-family residence or farm outbuilding. You may also build or improve a commercial buUd|n0, provided your costs do not exceed $75.000. The building or residence must be for your mvvn use or occupancy. It may not be built or substantially improved if for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor wrto supervise people working on your building. It is your responsibility to make sure that people employed by you have Uomnnem required by state law and bv county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be mnzo|oved by you, which mnmono that you must deduct F.I.C.A. and withholding tax and provide worker's compensation for that employee, all as prescribed by law. Your construction must comply with all applicable |axva, ordinances, building codes, and zoning regulations. OWNER'S SIGNATURE DATE ADDRESS pHONE WITNESS PERMIT ' '