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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BmLDIHG DEPARTKBNT I, _Kq.)}) \~-eY\~\"~~1..J..~ \. it,. have read and fuJ.~y understand and agree to the provision 0 this instrumeut. The undersi~ed states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own damici~e" that he or she actua~~y occupies, or wi~~ occupy by said damici~e, and same is not for rent, lease or sa~e. That he or she shal~ comp~y with the following conditions.: 1. That the owner and he or she alone shall act as the bui~der for all phases of construction. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. That in the event various phases of construction are subcontracted, he will engage o~y properly licensed subcontractors and wi~l personally supervise such work.. That in the event the Bui~ding Inspector shall require corrections to be made, the owner will assume fu~l responsibi~i ty to insure they are made, and upon completion will call for a reinspection before proceeding with the building. That the oWner shall assume fuJ.~ responsibi~ity for the construction and will not expect supervision of his work from the City of Zephyrhil~s Building Department. That prior to final inspection any additiona~ fees, including reinspection fees, must be paid in full. A written request from this office shall .constitute an official notice. to pay additional fees. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc., where applicable. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. State law requires construction to be done by licensed contractors. You have applied for a pe:rmi t 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 BY build or impr~ve .a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercia~ bui~ding, 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 sell or lease a building yoti have built or substantially iDi:proved yourself within 1 year after the construction is complete, the law wil~ presumetbat you built or substantially improved if for sa~e or lease, which is a violation of this exemption. You may not hire an. unJ.icensed 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 municipa~ 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 ~icensed must work under your direct supervision and must be employed by you, which means that you must deduct F.J:.C.A. and rithholding tax and provide workers' compensation for that employee, al~ as prescribed by 1aw. Your construction must comply with all app~icable laws, ordinances, building codes, and zoning re~at~ons. OWNER'S s;rGNATllRB~1-~* DATE ->-::to -0'/ ADDRESS ,V)' I~I'--- ,~~ . .,' hHr~'!_~S:' L. JS,UL PHONE t? I ~ - 7 e ~- :S 8 :;;l. D 9 . 2. 3. 4. 5. 6. 7.. 8. 9. r WJ:TNES S PERKJ:T #