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III I, DISCLOSURE STATEMENT FOR OWNER CITY ot ZEPHYRBILLS BUILDING DEPARTHENT ~ have read and fully understand and agree to the provisions of t is instrument. The undersigned states and a firms that he or she is desirous of constructing, renovating, adding to or rer ofing his or her own domicile" that he or she actually occupies, or will 0 qupy by said domicile, and same is not for rent, lease or sale. That h or she shall comply with the following conditions: 1. That the owner and he or .he alone shall act as the builder for all phases of construction. 2. That the owner will comp ~ with all provisions of the City of Zephyrhills ordinances and codes per inent to the building. 3. That in the event variou phases of construction are subcontracted, he will engage only properly lic sed subcontractors and will personally supervise such work. 4. That in the event the B 'lding Inspector shall require corrections to be made, the owner will assume f 1 responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. 5. That the owner shall ass e full responsibility for the construction and will not expect supervision f his work from the City of Zephyrhills Building Department. 6. That prior to additional fees, including reinspection fees, must be 11. A written request from this office shall constitute an officia~ otice to pay additional fees. 7. That the owner shall co 1y with all City, State and Federal laws in regard to social security, workm '8 compensation, lien laws, etc., where applicable. 8. That the owner shall co ly with all the safety codes issued by the Florida Industrial Commission. 9. State law requires cons ruction to be done by licensed contractors. You have applied for a permit un eo:" an exemption to that law. The exemption allows you, as the owner of yo property, to act as your own contractor with certain restrictions even thoug you do not have a license. You must provide direct onsite supervision of t e construction yourself. You may build or impr~ve a one-family or two-famil residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The building ~or residen e must be for your own use or occupancy. It may not be built or substantial y improved for sale or lease. If you sell or lease a building you have built dr substantially improved yourself within 1 year after the construction is co 1ete, the law will presume that you built or substantially improved ~ for sale or lease, which is a violation of this exemption. You may not ~ire an unlicensed person to act as your contractor or to supervise people wor ~ng on your building. It is your responsibility to make sure that people loyed by you have licenses required by state law and by county or municipal ~censing ordinances. You may not delegate the responsibility for supe ising 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 mus work under your direct supervision and must be employed by you, which ~ans that you must deduct F.I.C.A. and withholding tax and provide workers' co ensation for that employee, all as prescribed by law. Your construction must ~mply with all applicable laws, ordinances, building codes, and zoning regul tions. OWNER'S SIGNATURE ADDRESS PHONE DATE 9'- JtJ,-OS-; / WITNESS PERMIT #