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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, ~De r?ob/ick have I'ead and fully understand and agree tb the provisions of this instrument. The und~rsigned states and affirms that he or she is desirous of constructing, renovat'ng, adding to or reroofing his or her own c.omicile, that he or she actuall occupies, or will occupy by saic. domicile, and same is not for rent, lase or sale. That he or she shall comply ~'ith the fol1owing conditions: 1. Tha the owner and he or she alone sha1l act as the builder for al1 phases of con truction. Tha the owner wi11 comp1y with al1 provisions of the City of Zephyrhi1ls ord nances and codes pertinent to the bui1ding. Tha in the event various phases of constructic.n are subcontracted, he wi11 eng ge on1y proper1y licensed subcontractors ~.d wi11 persona11y supervise suc work. Tha in the event the Building Inspector shall require corrections to be made, the owner wi11 assume full responsibi1ity to iz:.sure they are made, and upon letion will call for a reinspection before proceeding with the building. the owner shall assume full responsibility' for the construction and wi1l expect supervision of his work from the Cit.y of Zephyrhills Building rtment. prior to final inspection any additional fees, including reinspection , must be paid in full. A written request from this office shall titute an official notice to pay additional fees. Tha the owner shall comply with all City, Stat;e and Federa1 laws in regard to soc'al security, workman's compensation, lien laws, etc., where applicab1e. Tha the owner sha11 comply with all the safety codes issued by the Florida Ind stria1 Commission. Sta e law requires construction to be done by licensed contractors. You have app ied for a permit under an exemption to that: law. The exemption al10ws you, as the owner of your property, to act as your own contractor with certain res rictions even though you do not have a lice,nse. You must provide direct ons'te supervision of the construction yourse11:. You may bui1d or improve a one-family or tWO-family residence or a farm outbuilding. You may a1so build or i prove a commercial building, provided youz' costs do not exceed $25,000. The uilding or residence must be for your own use or occupancy. It may not be b ilt or substantially improved for sale or lease. If you sell or lease a buil ing you have built or substantially improved yourself within 1 year after the onstruction is complete, the law will presiume that you built or subs antially improved if for sale or lease, which is a violation of this tion. You may not hire an unlicensed perslon to act as your contractor or pervise people working on your building. It is your responsibility to sure that people employed by you have licElnses required by state law and unty or municipal 1icensing ordinances. 1:ou may not delegate the nsibili ty for supervising work to a licenfled contractor who is not 1ice sed to perform the work being done. Any person working on your building who 's not licensed must work under your direct: supervision and must be empl yed by you, which means that you must dedllct F.I.C.A. and withho1ding tax and rovide workers' compensation for that empJ.oyee, all as prescribed by law. Your construction must comply with all applic~)le laws, ordinances, building code, and zoning zegulations~ 'S S3rq~~ rh;15, ;L-'>~::L DATE 1'-/3-~fo PRO /?f3 g- 53-I ~ ., WIT.~ ~ , 2. 3. 4. 5. 6. 7. 8. 9. PERMIT #