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D:ISCLOS'DRE STATEMENT FOR OWNER CJ:.TY OF -ZEPRYRH:ILLS BUJ:LDJ:NG DEPARTMENT :I, MI;E'Lfl, /Jt') Ld/J1~r- . have read and ful~y understand and agree to the provisions of this instrument. The undersi~ed states and affirms that he or she is desirous of constructing, renov.ating, adding to or reroofing his or her own domicile;, that he or she actually occupies, or wi~l occupy by said. domicile, and same is not for rent, ~ease or sa~e. That he or she shall comply with the following conditions.: ~. That the owner and. he or she alone shall act .as the builder.for all phases of construction. 2. That the ownerwil~ comply with all provi,,!ions of the City of Zephyrhills ordinances and codes pertinent to .the building. 3.. That in the event various phases of constructi~n are subcontracted, he will engage only properly ~icensed subcontractors and will personally supervise such work.- 4. That .in the event the Building :Inspector shall require corrections to be made, the owner will assume full. .responsibili ty to insure they are made, . and upon completio:c: wili call for a reinspection before proceeding with the building. .5. That the oW:c.er shall assume full responsibi.~ity for the construction and will not expect supervision of his work from the City of ZephyrhillsBuilding - Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office.shall ,constitute- an officia~ notice. to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws' in: regard to social aecuri ty ~ workman's compensation, lien laws, etc., where applicable. 8. That the owner shall comply with all the safety codes issued by. the Florida :Industrial Commission. - 9. State law requires construction to be done by licensed contractors. You have applied for a peDnit under an exemption to that law. The exemption allows you, as the owner of your property, 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 farm 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 s&ll.;or' lease. a building yoti _ have buil to.rsubstantial.ly impr.oved yourseifwi thi:e: l. year after the construction is complet~, the l.aw will presUme.tha:t you built: or substantially improved if for sale or lease, which is a. violation of this exemption. You may not hire an unlicens.ed person to act as your contractor or to supervise people working on your building. :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 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 wj,thholding tax- and provide workers' compensation for that employee, all as prescribed by iaw. Your construct~onau c~ly with all appli-cable laws, ordinances, building codes, and zo:z:u.ng eguI t.J.ons. . . , OWNER'S SIGNA:. DATE ;r /.:?/o7 r ADDRESS :.2 :r~L. :E'BONB WJ:'l'NESS PERMIT .. #: