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_ D:ISCLOSURE STATEMENT FOR OWNER ./..} i' C';,TY",OF. ZEPHY:R.lD:LLS BO'J:LD:ING DEPARTMENT :I, ~~f{;lQ, " have read and ful.~y understand and agree to the prov:Lsions of this instrument. The undersigned states and affi:rms that he er she is desirous of constructing, renovating, adding to or reroofing his or her own domici~e" that he or she actua~~y occupies, or wi~~ occupy by 't~ ~//Jc. said domici~e, and same is not for rent, ~ease or sa~e. That he or she s ~ comp~y with the fe~~owing conditions,: L That the owner and he er she a~one sha~~ act as the bui~derfor a~~ phases of censtruction. That the owner wi~~ comp~y with a~~ provisiens of the City of Zephyrhi~~s ordinances and codes pertinent to 'the bui~ding. That in the event various phases of construction are subcontracted, he wi~~ engage on~y proper~y ~icensed subcentractors and wi~~ persona~~y supervise such werk., That in the event the Bui~ding :Inspecter sha~~ requ:ire correctionS to be made, the owner wi~~ assume fu~~ respensibi~ity to insure the.y are made, and upon comp~etion wi~i ca~~ for a reinspectien befere proceeding with the bui~ding. That the oWner sha~~ assume ful.~ respensibiJ.ity fer the construction and wi~~ not expect supervision of his wrk from the City of Zephyrhi~~s Bui~ding Department. That prior to fina~ inspection any additio~ fees, inc~uding reinspection fees, must be paid in fuJ.~. A written request from this office sha~~ .constitute an officia~ notice. to pay additiona~ fees. That the owner sha~~ comp~y with a~~ City, State and Federa~ ~aws' in regard to secia~ security~ workman's compensation, ~ien ~aws, etc., where app~icab~e. That the owner sha~~ comp~y wi th a~~ the safety codes issued by the F~orida :Industria~ Commission. State ~aw requires construction to be done by ~icensed contractors. You have app~ied for' a permi. t under an exemptien to that ~aw. The exemptien a~~ows you, as the owner of your property, to act as your own contractor with certain. restrictions even though you do not have a ~icense. Yeu must provide direct onsite supervisien of the constructien yourse~f. You may bui~d or imprC?Ve .a one-fam.i~y or two-fam.i~y residence or a far.m outbui~ding. You may a~so bui~d or improve a ccmmercia~ bui~ding, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. :It may not be bui~t or. sUbstantia~~y improved for sa~e or ~ease. :If you s&l~:or' ~ease a bui~ding yotihave bui~t orsubstantia1~y .improved yourse~f within ~ year after the construction is comp~ete, the ~aw wi~~ presume .thAt you bui~t or substantia~~y improved if for sa~e or ~ease, which is a. vie~atien of this exemption. You may not hire an unl.icen.sed person to act as your contractor or to supervise peop~e working on your bui.~ding. :It is your responsibi~ity to make sure that peop~e emp~oyed by you have ~icenses requ:ired by state law and by county or municipa~ ~icensing ordinances. You may not de~egate the responsibi~ity fer supervising work to a ~icensed contractor who is not ~icensed to perform the work being dene. Any person working on your bui~ding who is not ~icensed must work under your direct supervision and must be emp~oyed by you, which means that you must deduct F.:I.C.A. and withho~ding tax and provide workers' c ensation for that emp~oyee, a~~ as prescribed by 1aw. Your construction must"' ~y wi th a~~ app~i'cab~e laws, ordinances, bu.i~ding codes, and zoning r at'ions. 2. 3. 4. 5. 6. 7. 8. 9. OWNER'S ADDRESS PHONE r WJ:TNESS PBRKJ:'l' #