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DISCLOS1JJUI SD.TBIIBII'1" I'Olil 0WJ1BR CITY OP ZBPBYJiB:[LLS B1T.I:LDDIG DBPAB.DIID1'l' t!" r II/)fj L3 (L / le~ have read and ful.1y understand and to the provisions of . s instrument. I, agree The undersigned states and affirms that he or she is desirous of constructing, renovating, addiDg to or reroofing his or her own domici1e, that he or she actua11y occupies, or w:i.11 occupy by said domici1e, and same is not for rent, 1ease or sa1e. That he or she sha11 comp1y w:i.th the f0110wing conditions: 1. That the owner and he or she a10ne sha11 act as the bui1der for a11. phases of constJ:uction. 2. That the owner w:i.11 comp1y with a11 provisions of the City of Zephyrhi11s ordi .........ees and codes pertinent to the bui1ding. 3. That in the event various phases of construction are subcontracted, he wi1l engage on1y proper1y 1icensed subcontractors and wi11 persona11y supexvise such work.. 4. That in the event the Buil.d:i.ng Inspector sha11 require corrections to be made, the owner w:i.1l. assume ful.1 responsibi1ity to insure they are made, and upon compl.etion wi1l. ca11 for a reinspeetion before proceeding with the buil.ding. 5. That the owner sha11 assume ful.l. responsibi1ity for the constJ:uction and wil.l. not expect supervision of his work from the City of Zephyrhi11s Bui1ding Department. 6. That prior to fiDal. inspection any additiona1 fees, inc1uding re.inspection fees, must be paid in ful.1. A written request from this office sha1l. constitute an officia1 notice to pay additional. fees. 7. That the owner sha1l. comp1y with a11 City,. State and Federal. 1aws in regard to socia1 security, workman's compensation, 1ien 1aws, etc., where app1ica1:l1e. 8. That the owner shal.l. comp1y with a1l. the Safety codes issued by the Florida :Industrial. Commission. 9. State law requires construction to be done by 1icensed contractors. You have app1ied for a permit under an exemption to that 1aw. The exemption a110ws you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a 1icense. You must provide direct onsi te supexvision of the construction yourse1f. You may bui1d or improve a one-fami1y or two-fami1y residence or a farm outbuil.ding. You may a1so bui1d or improve a cOllllllercial. bui1d.:i.ng, provided your costs do not exceed $25, 000 . The bui1ding or residence mu.st be for your own use or occupancy. It may not be buil. t or suhstantia1l.y improved for sa1e or l.ease. If you se11 or 1ease a . bui1ding you have built or suhstantia11y improved yourse1f within 1. year after the construction is complete, the l.aw will presume that you bui1t or substantia11yimproved if for sal.e or 1ease, wb.i.ch is a vi01ation of this exemption. You may not hire aD. 1D1l.iceused person to act as your contractor or to supervise people working on your bui1ding. It is your responsibility to make sure that peopl.e empl.oyed by you have l.icenses required by state law and by county or JIlUDicipa1 l.icensing ord.....ances. You may not del.egate the responsibil.i ty for supervising work to a 1icensed contractor who is not 1icensed to perform the work being done. Any perSOD. working on your building who is not 1icensed must work under your direct supervision and must be empl.oyed by you, wb.i.ch means that you must deduct F.I.C.A. and withhol.ding tax and provide workers' compensation for that empl.oyee, a1l as prescribed by l.aw. Your construction must compl.y with a1l app1icab1e 1aws, ordinances, building codes, and zoning regul.ations. OWBBR.' S ADDRESS PBORB DAD /- 3-0S- WITNESS PBRIaT #