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D:ISCLOSURE STATmmNT FOR OWNER CITY OF ZEPHYRB:ILLS BUJ:LD:ING DEPARTKENT ,: L7 '" $ k r:~ ~... agree to the provi . ns of :-J I< 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 actual~y occupies, or ~~~ occupy by said domicile, and same is net for rent, ~ease or sale. That he or she shall comply with the following conditions.: ~. That the owner and he er she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all 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 will engage only properly licensed subcontracters and ~ll personally supervise such work.. 4. That in the event the Building :Inspector shall require corrections to be made, the ewner will~ assume full responsibility to insure the;y are made, and upon completion will call for a reinspection befere proceeding ~th the 'building. 5. That the oWner shall assume fuJ.l responsibi'lity for the constructien and will net expect supervision of his Work from the City of Zephyrhills Building Department. 6. That prior to final inspectien any additional fees, includi:ngreinspection 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 shall comply with all City, State and Federal laws' in regard to social security, workman's compensation, lien laws, etc., where applicable. 8. That the owner shall comply ~ th all the safety cedes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. Yeu have applied for a permit under an exemption to that law. The exemptien allows you, as the own.er of your property, to act as your own centractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the censtruction yourself. You may build or improve .a one-family or two-family residence or a far.m outbuilding. You may also'build or improve a commercial building, provided your costs do not exceed $25,000. The building er residence. must be for your own use er occupancy. :It may not be built or. sUbstantially improved 'for sale er lease. :If you seJ..J.;or" ~ease a building you have built or substantially improved yourself within 1 year after the constructien is complete, the law will presume 'th&t you built or substantially improved if for sale or lease, which is a. violation of this exemption. You may net hire an unlicens'ed persen to act as your contractor or to supervise people working on yeur building. :It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility fer supervising work to a licensed contracter who is not ~icensed to perform the werk being dene. Any person working on your building who is not ~icensed must work under your direct supervision and must be employed by you, which means that you must deduct F.:I.C.A. and w:tthho~ding tax and provide workers' compensation for that emp~oyee, a~l as prescribed by 1aw. Your construction must comply ~ th al~ app~icable laws, ordina:c.ces, bui~ding codes. and zoning z.gula.'~ .. ==~ .""'1;7'" r-t-\~iWli/ n DATB 07.~/6- Ot? f PHONE :3 r? ~ .;!(u - at:, q5' WJ:'l'NESS PBRMJ:'l' #