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- I, [io--n.h l t/ agree to the previsious of ~s instrument. ~frt l-h, , DISCLOS1JRE S1'ATBldENTp'OR. OWN.Jm. CJ:n OF -ZEPlrYJUIILLS B'D'ILDING DEPU1'!Imr.r ' . have read and ful'ly understand and 1'he undersi~ed states and affirms that he or she is desirous of Coustructing, renovating, adding to or reroofing his or her own domicile;, that he or she actually occupies, or will occupy by ,.'sai.d domicile; and SBIDe is not for rent, lease or sa'le. That he or she shall comply .with the fOllowing conditions,: 'l.:rhatthe owner and. he or she alone shaJ.I act. as the builder 'for all phases of, construction. .2. !'hat the owner will comply with all previE!ions of the City of Zephy.rhills ordinances and codes pertinent to -the building. 3. !'hat in the event various phases of constructi~n are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work., .. ,"",,~in the even~ the "ui1<Ung :tnspec~or .hal1 r.quire .orrac~iODS 1;0 be _, the owner will aSSUDle full' responsibility to insure they are made, 'and upon completion wili call for a reinspection before proceeding with the building. 5. :rhat the oWner shall assume ful.l responsibi'lity for the construction and will not expect SUPervision of his Work from the Ci ty of Zephy.rhillsBuilding Department. 6. !'hat prior to fi.nal inspection any additional fees, inclUding reinspection fees, must be paid in full. A written request. from this office shall ,constitute' an officia2 notice. to pay additional fees. 7. ""'~ the owner shall camp1y .....th "'-1 City, S~a"" """ .....era1 laws. in r.gar,! 1;0 social security, workman's compensation, lien laws, etc., where applicable. a. ""'~ the owner shall camp1y .....th "'-1 the safety co..... i..ue.. ~ the Flori.... Industrial Commission. , 9. S~al;e law r.quires c=S"=~i= 1;0 b. <lone ~ license.. contractor.. You ""ve applied for' a pe.onit under an exemption to that law. 1'he exemption allows you, a. the owner of """" property, ~o ac~ a. your own c=~racl;or .....th certain restrictions even though you do not have a license. You must previde direct ond~e .""ervisio.u of the c=S"=ti"" """"a.'f. You may bui1.. or impr,?,,"a one-fam:i.ly or two-fam:i.ly, residence or a farm OUtbuilding. You may also build or improve a commercial building, provided'your costs do not exceed $25,000. Th. bui1<Ung or resi""=e -.1; b. for your own us. or occ"""""". It; may DOl; be bui1~ or. eUb.~""tia11y imprqve.. for .02. or '"".e, rf you ..U:or" lease a bui1<Ung YOU.""ve bui1~ or ~ub.~anl;io2ly imp<ove.. yourSelf wit;bin 1 year af~er the constX11ction is complete, the law will presUme 'thclt you built: or . SubstantiallY!mprcvedif for sale or lease, which is a violation of this exemption. You may DOl; hire an UDlicenae.. per.on ~o ac~ as """" contrac~or or ~o .""ervi.e people working o.u your building. I~ i. """" responsibili ty ~c make sure tha~ people employe" by you ha.... license. r.quir... ~ .I;a~. law ami by county or municipal licensing ordinances. You may not, delegate the responsibility for supervising work to a licensed contractor who is not license.. to Perfo"," the Work being <lone. Any per.on working on your building who .is not ~.icensed must Work under your d.i.rect superv.is.ion and must be employe" ~ you, whi "" ........ tha~ you mus~ d.duc~ F. I. ".A. and wi _, ding tax. and previ.... WOrker.' campen.ation for that emp1oy..e, all as prescribed ~ iaw. Your construction must Comply with all appli~ab1. law., ordinance.. building Codes, and zoning regu at~ons. OWNER's ADDREss i'BO!n!: DAn / ~ / II!). /0 to . ( f r WI'l':NEss PElUa::r.. #: