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D:ISCLOSlJRE STATEMENT FOR OWNER C:I.TY OF -ZEPHYRH:ILLS B'D':ILD:ING DEPARTMENT :I J..-:-"" have read and fu1~y understand and I -,-,,~"4.,"JNtf)rnf() agree to the provisions of this instrument. The undersi~ed states and affirms that he or she is desirous of constructing I renov.atingl adding to or reroofing his or her own domicile~, that he or she actually occupies, or will occupy by 'said domicile, and same is, not for rent I ~ease or sa~e. That he or she shall comply ,with the ;following conditions,: ~. That the owner and,he or she alone shall aetas the builder -for all phas~s of construction. That the owner ,will comply with all provil:lions of the City of Zephyrhills ordinances and codes pertinent to -the building. That in the event various phases of constructi~n are subcoritractedl he will engage only properly ~icensed subcontractors and will personally supervise such work., That in the event the Building :Inspector shall require corrections to be madel the owner will assume fu1l'responsibili ty to insure they are made , 'and upon completion wili call for a reinspection before proceeding with the building. That the oWner shall assume full. responsibi~ity for the construction and will not expect supervision of his Work from, the City of ZephyrhillsBUilding Department. That prior to final inspection any additional fees, including reinspection fees I must be paid in fu1l. A written request from this office shall ,constitute' an officia~ notice. to pay additional fees. That the owner shall comply with all City I State and Federal laws' in- regard to social security I workman' s compensat~onl lien lawsl etc. I where applicable. That the owner shall comply with all the sa.fety codes issued by the Florida Industrial Commission. ' State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the own,er of your propertYI to act as your own contractor with certain 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 residence or a f~ outbuilding. You may also "build or improve a commercial 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 you_have built or ,substantiallY ~roved yourself, within' 1. year after the construction is cCmplet~, the law will presUme 'that you built or, substantially improved if for sale or leasel which is a, violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your buildi:c.g. It is your responsibility to make sure that people 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 wor.k 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 witl::lhold.ing tax' and provide workers' compensation for that employee, a.ll. as prescribed by iaw. Your construction must comply with a.ll applicable laws, ordinances, building :=: S ~:;::: regul.~o~.., ,. I ~ 7- 0 0, ~ ADDRESS Lt-, .'- DATE E'BO:m:: 2. 3,. 4. 5. 6. 7. B. 9. .r WITNESS ~ 1 Q 1l.A...A....... PEIOCI:T, # to3dLf