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DISCLOSURE STATEMENT FOR OWNER CI.'l'Y OF ZEPRY:R.BILLS BUJ:LDDlG DEPARTMENT I, (LoSe t-, '3edt00'Sil-V have read and :EuJ.~y understand and agree to the prov~s~ons o:E t~s ~nstrument. The unders~g.ned states and a:E:E~r.ms that he or she ~s des~rous o:E construct~ng, renov.at~ng, add:i.ng to or reroo:E~ng his or her own dom.ic~~e~, that he or she actua~~y occup~es, or ~~~ occupy bysa~d domic~~e, and same ~s not for rent, ~ease or sa~e. That he or she sha~~ comp~y w~th the :Eo~~ow~ng cond:i.t~ons,: ~. That the owner and he or she a~one shaJ.~ act as the bui~der:Eor a~~ phases o:E.. construct~on. 2. That the owner w~~~ comp~y w~th a.J.~ prov~s~ons o:E the C~ ty o:E Zephyrh:i.~~s ordinances and codes pertinent to -the bui~d:i.ng. 3. That ~n the event var~ous phases o:E construct~~n are subcontracted, he w~~l engage o~y properly ~~censed subcontractors and wi~~ persona~~y supervise such work., 4. That in the event the Build:i.ng Inspector sha~~ require correct~ons to be made, the owner w~~~ assume :EuJ.~ responsib~~~ty to insure they are made, and upon complet~on wi~i ca~~ :Eor a re~nspect~on be:Eore proceed:i.ng ~th the bu~~ding. 5 . That the oWner shall assume :Eull responsib~~~ ty :Eor the construct~on and ~~~ not expect superv~s~on o:E h:i.s Work :Erom the City o:E Zephyrhil~s Bui~ding Department. 6. That prior to :E~nal ~nspect~on any add:i.t~ona~ :Eees, inc~uding reinspect~on :Eees, must be pa~d in :EuJ.~. A written request :Erom this o:E:Eice sha~~ const~tute' an o:E:E~c~a~ notice. to pay addit~o~ :Eees. 7. That the owner shal~ comply ~th a~~ C~ty, State and Federa~ laws' ~n regard to soc~a~ secur~ty, workman' s compensat~on, ~~en ~aws, etc., where app~icable. 8. That the owner shall comp~y wi th a~l the sa:Eety codes ~ssued by the Florida J:ndustria~ Commiss~on. . 9. State law requires construct~on to be done by ~~censed contractors. You have appl~ed :Eor' a pe%:1l1it under an exemption to that ~aw. The exemption a~lows you, as the owner o:E your property, to act as your own contractor ~th certa~n restrictions even though you do not have a l~cense. You must provide d:i.rect onsite supervision o:E the construction yourse~:E. You may bui~d or impr~e ,a one-:Eamd~y or two-famdly res~dence or a farm outbuild:i.ng. You may a~so bu~ld or improve a commerc~al bui~d:i.ng, provided your costs do not exceed $25,000. The bu~~d:i.ng or residence must be for your own use or occupancy. It may not be built or. s~stant~a~ly improved' 'for sale. or ~ease,; If you seJ.~':or' lease a build:i.ng yoti. have bu~l torsubstantia~ly improved yourself within 1 year a:Eter the construct~on is comp~ete, the ~aw wi~~ presUme 'that you bui~t or substant~a~ly improved ~:E for sa~e or ~ease, which ~s a. violation o:E this exempt~on. You may not hire an un1.~censed person to act as your contractor or to superv~se people working on your bu~lding. It ~s your respo:c.s:Lbi~i ty to make sure that people emp~oyed by you have l~censes required by state law and by county or municipal ~icens~ng ord:i.nances. You may not delegate the responsibi~~ty for supervis~ng work to a licensed contractor who is not l~censed to perform the work being done. Any person working on your build:i.ng who :i.s not l:i.censed must work under your d:i.rect superv:i.s:i.on and must be employed by you, wh:i.ch means that you must deduct F.J:.C.A. and withhold:i.ng tax and prov~de workers' compensat~on for that employee, a~l as prescr:Lbed by iaw. Your construct~on must comply w~ th a~~ appl~'cable laws I ordinances I building codes, and ion~ng re~at~ons. ' ,..---' . OWNER'S SIGNA'l'URE I,]' ~ (' ~~ , DATE/:J.-.~, tJl:, r ADDRESS 7::>1 -3. \<1. 7-0C4. 1....."10<; DI).. 'Z-L.c~'"i F->. \.4' lIS ~ \. '33"5~L E'HONE ( ~\~ ') (IS 1.021",,1' .'. WJ:TNESS E'ElUaT.. #: