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DJ:SCLOSURE STATEMENT FOR OWNER CJ:TY OF ZEPHYlU(J:LLS Bt1J:LDJ:NG DEPARTMENT J:, ~)a ~ p s E, ( J : -/ r '( <j agree to the provisions of this instrument. have read and ful~y understand and The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domici~e" that he or she actua~~y occup~es, or ~~~ occupy by said domic~~e, and same is not for rent, ~ease or sa~e. That he or she sha~~ comp~y with the fo~~owing conditions.: ~. That the owner and he or she a~one sha~~ act as the bui~der for a~~ phases of construction. 2. That the owner wi~~ comp~y with al~ provisions of the City of Zephyrhi~~s ordinances and codes pertinent to 'the bui~ding. 3 . That in the event various phases of construction are subcontracted, he wi~~ engage o~y proper~y ~icensed subcontractors and ~~~ persona~~y supervise such work.. 4. That in the event the Bui~ding J:nspector sha~~ require corrections to be made, the owner wi~~ assume ful~ responsibi~~ty to insure they are made, and upon camp~etion wi~i cal~ for a reinspection before proceeding ~th the .bui~ding. 5. That the owner sha~~ assume fu~~ responsibi~ity for the construction and wi~~ not expect supervision of h~s work from the C~ ty of Zephyrhi~~s Bui~ding Department. 6. That prior to fina~ inspection any additiona~ fees, inc~uding reinspect~on fees, must be paid in ful~. A written request from this office sha~~ .constitute an officia~ notice, to pay additional fees. 7. That the owner sha~~ comp~y with a~~ City, State and Pedera~ ~aws' in regard to socia~ security, workman's compensation, lien ~aws, etc., where applicable. 8. That the owner shal~ comp~y ~th a~~ the safety codes issued by the Florida J:ndustria~ Commission. . 9. State ~aw requires construction to be done by licensed contractors. You have applied for a peJ:mi.t under an exemption to that law. 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 ~icense. You must provide direct onsite supervision of the construction yourself. You may bui~d or ~r~ea one-fami~y or tW'O-fami~y residence or a far.m outbui~ding. You may also bui~d or improve a commercia~ building, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. J:t may not be built or sUbstantia~~y ~rovedfor sa~e or ~ease~ J:f you seal ;or lease a bui~ding yoti have bui~t orsubstantiaJ.~y i.m.Pr.oved you.:i:::se~f within. 1 year after the construction is comp~ete, the ~aw wi~~ presume .th&t you bui~t or substantia~~y improved if for sa~e or lease, which is a vio~ation of this exemption. You may not hire an un1icensed person to act as your contractor or to supervise peop~e working on your buildi.I1g. J:t is your responsibiJ.ity to make sure that peop~e emp~oyed by you have ~icenses required by state law and by county or municipa~ licensing ordinances. You may not deJ.egate the responsibi~ity for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your bui~ding who is not l~censed must work under your direct supervision and must be emp~oyed by you, which mems that you must deduct F.J:.C.A. and ,dthholding tax and provide workers' compensat~on for that emp~oyee, a~J. as prescribed by law. Your construct~on must co~lY ~th a~0 app~~cable laws, ordinances, bui~ding codes, and zoxung re ~at.J.ons. OWNER'S ADDRESS :E'RONE DATE f/;.~ 7; d~6 b r WJ:TNESS :E'ERMJ:T #