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- DISCLOSURE STATmmNT FOR OWNER CITY OF ZEPHYRBILLS BUILDING DEPARTMENT have read and fully understand and G~PVl!ltip.a. adding to actually occu;ies~ or rent, 1ease or sa1e: The undersigned states and affirms that he or she is desirous of constructing, or reroofin~ his or her own domicile" that he or she will occupy by said domicile, and same is not for That he or she sha11 comply 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 Zephyrhills ordinances and codes pertinent to'the building. 3. That in the event various phases of construction are subcontracted, he wi11 engage only properly licensed subcontractors and will personally supervise such work.. 4. That in the event the Building Inspector shall require corrections to be madel the owner will assume full responsibi1ity to insure they are made, and upon comp1etion will call for a reinspectionbefore proceeding with the building. 5. That the owner sha11 assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhi11s Building Department. 6. That prior to final inspection any additiona1 fees, inc1uding reinspection fees, must be paid in full. A written request from this office shall constitute an officia~ notice. to pay additional fees. 7. That the owner sha11 comp1y with a11 City, State and Federal laws' in regard to social security, workman's compensation, lien laws, etc., where applicab1e. 8. That the owner sha11 comp1y with all the safety codes issued by the Florida Industria1 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 a110ws 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 impr~e a one-family or two-fami1y 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 built or. substantially improved for sa1e or lease. If you s~l ;or' lease a building you have built or substantia1ly improved yourse1f within 1 year after the construction is complete, the law will presume that you built or Substantially improved if for sa1e or 1ease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building. It is your responsibi1ity to make sure that peop1e employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibi1ity 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 employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by 1aw. Your construction must comply with all app1icab1e 1aws, ordinances, building codes, and zoning e 1ations. OWNER'S ADDRESS PHONE DATE c2/t;/ (j b r , / WITNESS PERKIT #