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I, ~A'f agree to the DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRBILLS BUILDING DEPARTKENT Sa sfa tet\ej\e. provisions of this instrument. have read and fully 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 actua1ly occupies, or wi11 occupy by said domicile, and same is not for rent, lease or sale. That he or she shal1 comply with the fo1lowing conditions: 1. That the owner and he or she alone shall act as the builder for all phases of construction. 2. That the owner will comp1y with all provisions of the City of Zephyrhil1s ordinances and codes pertinent to .the building. 3. That in the event various phases of construction are subcontracted, he will engage on1y proper1y licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner wil1 assume full responsibility to insure they are made, and upon completion wi1l call for a reinspection before proceeding with thebui1ding. 5. That the owner sha11 assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhil1s Bui1ding Department. 6. That prior to final inspection any additiona1 fees, inc1uding reinspection fees, must be paid in fu11. A written request from this office shall .constitute an officia~ notice. to pay additional fees. 7. That the owner sha1l comp1y with all City, State and Federa1 laws' in regard to social security, workman's compensation, lien 1aws, etc., where applicable. 8. That the owner sha11 comp1y with all the safety 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 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 build or ~r~ea one-family or two-family residence or a farm outbui1ding. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The bui1ding "or residence must be for your own use or occupancy. It may not be bui1t or substantia11y improved for sale or lease. If you s&al;or lease a bui1ding you have bui1t or substantia1ly improved yourse1f within 1 year after the construction is complete, the law wil1 presume that you built or substantia1ly 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 bui1ding. It is your responsibi1ity to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not de1egate the responsibility for supervising work to a licensed contractor who is not 1icensed to perform the work being done. Any person working on your building who is not 1icensed must work under your direct supervision and must be emp10yed by you, which means that you must deduct F.I.C.A. and withho1ding tax and provide workers' compensation for that emp1oyee, all as prescribed by 1aw. Your construction must comply with a1l app1icab1e laws, ordinances, bui1ding co4es, and zoning regulations.. __ ~_ =~~ :3Q~ -rt~~'~ DATE --:JOv, 3OJOep, PHONE .5' lq- 371{- SIo t:;'7 WITNE~ PERMIT #: