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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, /)10rJO /-I-al'rJ Y1~ +- "(obert f-.Ia rffni.vnave read and .fu~~y understand and agree to the provisio s ofthisinstrument:7~r The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domi.ci~e, that he or she ~ctua~~y occupies, or wi~~ occupy by said domici~e, and same is not for rent, lease or sa~e. That he or she sha~~ comp~y with 'the fo~~owing conditions: ~. That the owner and he or she a~one shal.~ act as the bui~der'for a~~ phases of cons truction. 2. That .the owner wi'~~ comp~y wi th a~~ provisions of the City of Zephyrhi~~s ordinances ~d codes pertinent to the bui~ding. 3. That in the event various phases of construction are subcontracted, he wi~~ engage on~y proper~y licensed subcontractors and wi~~ persona~~y supervise such work. 4. That in the event the Bui~ding Inspectorsha~~ require corrections to be made, the owner wi~~ assumefu~~ responsibi~ity to insure they are made, and upon comp~etionwi~~ ca~~ for a reinspection before proceeding with the bui~ding. 5. That the owner shal.~ assumefu~~ responsibi~i ty for the construction and wi~~ not expect supervision of his work from the City of Zephyrhills Bui~ding Department. 6. That prior tofina~ inspection any addi.tiona~ fees, inc~uding reinspection fees, must be paid in fu~~. A wri:tten request from this office sha~~ constitute an official. notice to pay additiona~ fees. 7. That the owner sha~~ comp~y wi tha~~ City, State and Federa~ ~aws in regard to socia~ security, workman's compensation, lien ~aws, etc., where app~icab~e. 8. That the owner sha~l comp~y with al~ 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 permit under an exemption to that law. The exemption a~~ows 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 bui~d or improve a one-family or two-family residence or a farm outbui~ding, You may a~so bui~d or improve a commercial. 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 substantial.~y improved for sale or ~ease. If you se~~ or ~ease a bui~ding you have built or substantia~~y improved yourself wi thin 1 year after the construction is comp~ete, the law will presume that you bui~t or substantia~~y improved if for sale or ~ease, which is a violation of this exemption. You may not hire an un~icensed person to act as your contractor or to supervise people working on your building. It is your responsibi~ity to make sure that peop~e emp~oyed by you have ~icenses required by state law and by county or municipa~ licensing ordinances. You may not delegate the responsibi~ity for supervising work to a ~icensed contractor who is not ~icensed 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 withholding tax and provide workers' compensation for that employee, a~l as prescribed by ~aw. Your construction must comp~y wi th a~l applicable laws, ordinances, bui.~ding codes, and Z~:i2kations. =~~;:7Y~fj(f!i~;t~~~dfJI Hq~ WITNESS~ '"-'" ~< ~, PERMIT *