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DJ:SCLOSURE STATEMENT FOR OWNER .1 CJ:TY OF ZEPHYRHJ:LLS BUILDJ:NG DEPARTMENT r., (j U .R Ai . 7/i 1./ ERA <;. have read and fu11y agree to the provisions of this instrument. understand and The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile" that he or she actua11y occupies, or wi11 occupy by said domicile, and same is not for rent, lease or sale. That he or she sha11 comp1y with the following conditions.: 1. That the owner and he or she alone sha11 act as the builder for all phases of construction. 2. That the owner will comp1y with a11 provisions of the City of Zephyrhi11s ordinances and codes pertinent to -the bui 1 ding . 3. That in the event various phases of construction are subcontracted, he wi11 engage only properly licensed subcontractors and will persona11y supervise such work.. 4. That in the event the Bui1ding J:nspector shall require corrections to be made, the owner wi11 assume full responsibility to insure they are made, and upon comp1etion wi11 ca11 for a reinspection before proceeding with the building. 5. That the owner shall assume fu11 responsibility for the construction and wi11 not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to fina1 inspection any additiona1 fees, including reinspection fees, must be paid in fu11. A written request from this office sha11 constitute an official notice_to pay additional fees. 7. That the owner shall comp1y with all City, State and Federal laws' in regard to social security, workman's compensation, lien 1aws, etc., where applicable. 8. That the owner sha11 comp1y with a11 the safety codes issued by the F10rida J:ndustria1 Commission. 9. State law requires construction to be done by licensed contractors. You have app1ied for a permit under an exemption to that 1aw. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may bui1d or impr~ea one-family or two-family residence or a farm outbuilding. You may a1so build or improve a commercial bui1ding, provided your costs do not exceed $25,000. The bui1ding .or residence must be for your own use or occupancy. J:t may not be built or substantia11y improved for sale or lease. J:f you seal ;o~ lease a building you have bui1t orsUbstantia11y improved yourse1f within 1 year after the construction is complete, the 1aw wi11 presume that you built or substantially improved if for sale or 1ease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise peop1e working on your bui 1 ding . J:t is your responsibi1i ty to make sure that people employed by you have licenses required by state 1aw and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not 1icensed to perform the work being done. Any person working on your bui1ding who is not 1icensed must work under your direct supervision and must be emp10yed by you, which means that you must deduct !'.J:.C.A. and withh01ding tax and p,rovide workers' compensation for that emp10yee, a11 as prescribed by law. Your construction must comply with all applicable laws, ordinances, bui1ding codes, and zoning regu1ations. OWNER'S SJ:GNATURE d~ ~ DATE 0.:1- 01- 0 (f, ADDRESS Sg'fb Ifo1H St:" 'ZcPfiYRHrLC5 t-=(.335tf.:J PHONE. <l.13- 7/5- '-/.(73 . WJ:TNESS PERMJ:T #