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DISCLOSURE STATEMENT FOR OWNER CITY OF -ZEPRYRHILLS BUILDING DEPARTMENT I,DA\J'.D S14eAi: S have read and fuJ.~y understand and agree to the prov~s~ons of thi's ~nst:rument. The unders~gned states and affirms that he or she' is desirous of constructing, renov.at~ng, adding to or reroofing his or her own domicile~, that he or she actually occup~es, or ~ll occupy by said domicile, and same is not for rent, ~ease or sale. That he or she shall complyw~th the follow~ng condit~oI1S,: ~ . That the owner and he or she alone shall act as the builder for all phases of" constructi.on. 2. That the owner w~l~ comply w~th al~ provi.si.ons of the City of Zephyrhills ordinances and codes perti.nent to 'the building. 3. That in the event var~ousphases of constructi.on are subcontracted, he ~ll engage only properly li.censed subcontractors and ~ll personally superv~se such work., 4. Thati.n the event the Building Inspector shall requ:i.re correct~ons to be made, the owner w~ll assume fuJ.lresponsib~l~ty to ~nsure they are made, 'and upon complet~on wili call for a rei.nspecti.on before proceeding ~th the building. 5. That the oWner shall assume fuJ..l responsibi.~i.ty for the construct~on and will not expect supe:rv~s~on of his Work from the C~ ty of Zephyrhills Building Department. 6. That pr~or to f~nal ~nspect~on any addit~onal fees, including re~nspect~on fees, must be paid ~n fuJ.l. A written request from this off~ce shall ,const~tute' an off~c~al not~ce_to pay addi.t~onal fees. 7. That the owner shall comply ~th all C~ty, State and P'ederallaws' ~n regard to soci.al secur~ty~ worlanan's compensati.on, l~en laws, etc., wherEl appl~cable. 8. That the owner shall comply ~ th all the safety codes issued by the Flor~da Industri.al Commission. 9. State law requ:i.res constructi.on to be done by li.censed contractors. You have applied for' a pe:cni.t under an exempt~on to that law. The exempt~on allows you, as the owner of your property, to act as your own contractor ~th certa~n, restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may build or improve .a one-family or two-family resi.dence or a farm outbuilding. You may also'build or improve a commerc~al building, provided your costs do not exceed $25,000. The building or residence, must be for your own use or occupancy. It may not be built or, sUbstantially improved'for sale or lease. If you seJ.l;or' lease a building yoti., have built or ,substantially improved you:i:,self ~thin 1 year after the const~ct~on is complete, the law will presume.that you built or substantially improved ~f for sale or lease, which is a, violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people worlci.ng on your bu~lding. It ~s your responsibi.l~ty to make sure that people employed by you have licenses requ:i.red by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supe:rvis~ng work to a l~censed contractor who is not l~censed to perform the work be~ng done. Any person working on your building who is not l~censed must work under your direct supe:rv~si.on and must be employed by you. wh:i.ch means that you must deduct F.J:.C.A. and w:Lthholding tax and provide workers' compensat~on for that employee. all as prescribed by iaw. Your construction must comply w~ th 1 appli'cable laws. ordinances. bu~lding codes, and zon~ng re ti. ns. OWNER'S ADDRESS PHONE SJ:GNATURE vJ, ' (yc(52 (>')O...\< (')\QJ)-\- ~. -t! de) , DATE --3Jd-~ t'l.OOl.o r WITNESS PERMJ:T" #