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<br />DJ:SCLOSURE STATEMENT FOR OWNER <br />CJ:TY OF ZEPHYRBJ:LLS BUJ:LDJ:NG DEPAR'l'KENT <br /> <br />J:, , ~.;\~~~. f. C C~y-ci-\ 'Q.,... have read and ful~y understand and <br />agree to the prov:LS:Lons of this :Lnstrumeut. <br /> <br />The undersi~ed states and affirms that he or she is desirous of constructing, <br />renovating, adding to or reroofing his or her own domici~e,. that he or she <br />actua~~y occupies, or wi~~ occupy by said domici~e, and same is not for <br />rent, ~ease or sa~e. That he or she sha~~ comp~y with the fo~~owing conditions,: <br /> <br />~. That the owner and he or she a~one sha~~ act as the bui~der for a~~ phases of <br />construction. <br />2. That the owner wi~~ comp~y with a~~ provisions of the City of Zephyrhi~~s <br />ordinances and codes pertinent to the bui~ding. <br />3. That in the event various phases of construction are subcontracted, he wi~~ <br />engage on~y proper~y ~icensed subcontractors and wi~~ persona~~y supervise <br />such work.. <br />4. That in the event the Bui~ding J:nspector sha~~ require corrections to be made, <br />the owner wi~~ assume fu~~ responsibi~ity to insure they are made, and upon <br />comp~etion wi~~ ca~~ for a reinspection before proceeding with the 'bui~ding. <br />5. That the oWner sha~~ assume ful~ responsibi'~ity for the construction and wi~~ <br />not expect supervision of his Work from the City of Zephyrhi~~s Bui~ding <br />Department. <br />6. That prior to fina~ inspection any additiona~ fees, inc~uding reinspection <br />fees, must be paid in fu~~. A written request from this office sha~~ <br />,constitute an officia~ notice. to pay additio~ fees. <br />7. That the owner sha~~ comp~y with a~~ City, State and Federa~ ~aws' in regard to <br />socia~ security, workman's compensation, ~ien ~aws, etc., where app~icab~e. <br />8. That the owner sha~~ comp~y with a~~ the safety codes issued by the F~orida <br />Industria~ Commission. <br />9. State ~aw requires construction to be done by ~icensed contractors. You have <br />app~ied for a permit under an exemption to that ~aw. The exemption a~~ows <br />you, as the owner of your property, to act as your own contractor with certain, <br />restrictions even though you do not have a ~icense. You must provide direct <br />onsite supervision of the construction yourse~f. You may bui~d or ~r~vea <br />one-fami~y or two-fami~y residence or a farm outbui~ding. You may a~so bui~d <br />or improve a ccmmercia~ bui~ding, provided your costs do not exceed $25,000. <br />The bui~ding or residence must be for your own use or occupancy. It may not <br />be bui~t or sUbstantia~~y improved for sa~e or ~ease. If you se~~ or ~ease a <br />bui~ding yoti have bui~t orsubstantia~ly improved yourself within 1 year after <br />the construction is comp~et~, the 1aw wi~~ presume that you bui1t or <br />substantia~~y improved if for sa~e or ~ease, which is a vio~ation of this <br />exemption. You may not hire an, uul.icensed person to act as your contractor or <br />to supervise peop~e working on your bui~ding. It is your responsibi~ity to <br />make sure that peop1e emp~oyed by you have ~icenses required by state ~aw and <br />by county or municipa~ ~icensing ordinances. You may not de~egate the <br />responsibi~ity for supervising work to a ~icensed contractor who is not <br />licensed to perform the work being done. Any person working on your bui~ding <br />who is not licensed must work UDder your direct supervision and must be <br />emp10yed by you, which mems that you must deduct F.I.C.A. and withho1d.ing tax <br />and provide workers' compensation for that emp10yee, a11 as prescribed by ~aw. <br />Your construction must comp~y with a~~ app~icab~e ~aws, ordinances, bui1ding <br />codes, and zoning regu~ations. <br /> <br />OWNER'S SIGNATURE V~ r~~~ <br />ADDRESS <br />PHONE <br /> <br />DATE <br /> <br />Z!JZ/07r <br /> <br />WITNESS <br /> <br />PERMIT # <br />