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D:ISCLOSURE STATEMENT FOR OWNER () C~TY OF" -ZEPRYRH:ILLS BU:ILD:ING DEPARTMENT :I, C y tt z-- A li-M 2-d k -Lhave read and, fuJ.~y agree to the provisions of this instrument. understand and' The undersi~ed 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 occupies, or wi~~ occupy by said domici~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.J.~ act as the bui~der 'for a~~ phases of " construction. 2. That the owner wi~~ comp~y with a~~ 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 wi~~ persona~~y supervise such work." 4 . That in the event the Bui~ding :Inspector sha~~ require corrections to be made, the owner wi~~ assume fuJ.~responsibi~ity to insure they are made, and upon comp~etion wi~i cal~ for a reinspection before proceeding with the bui~ding. 5. That the oWner sha~~ assume fuJ.J. responsib.i~ity for the construction and wi~~ not expect supervision of his Work from the City of Zephyrhi~~s Bui~ding Department. 6. That prior to ~inal inspection any additiona~ fees, inc~uding reinspection fees, must be paid in fuJ.~. A written request from this office shall . constitute' an officia~ notice,to pay additional fees. 7. That the owner shal~ comply with a~~ City, State and Federal ~aws' in regard to social security, workman's compensation, lien ~aws" etc., where app~icable. 8 . That the owner shal~ comp~y wi th a~l the safety codes issued by the Florida :Industria~ Commission. . 9. State ~aw requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that ~aw. The exemption a~lows 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 yourse~f. You may build or impr~e .a one-fami~y or tWO-family residence or a far.m outbui~ding. You may a~so bui~d or improve a commercial building, 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 built or s~stantial~y improved for sale or lease. :If you s~~ ;or' lease a bui~ding yotihave built or .substantia~ly improved your~elf within 1 year after the construction is comp~ete, the law wi~~ presUme "that you built or substantially improved if for sa~e or lease, which is a violation of this exemption. You may not hire an ~icensed person to act as your contractor or to supervise people working on your building. :It is your responsibi~i ty to make sure that peop~e employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not, delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must 'deduct F.I.C.A. and rlthholding tax' and provide workers' compensation for that employee, a~l as prescribed by 1aw. Your construction must comply wi th a~~ appli-cable laws, ordinances, building codes, and zoning r~e' ations. ," OWNER'S SIGNATURE _~ 0..' _ hL:'r ~.~L DATE 9-0 -Cl 6 r ADDRESS ~ l'RONE WITNESS PElUC:T " #: