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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, / agree have read and:ful.l.y understand and this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, that he or she actual.l.y occupies, or wil.l. occupy by said domicil.e, and same is not for rent, lease or sal.e. That he or she shal.l. compl.y with .the :foll.owing conditions: 1.. That the owner and he or she al.one shal.l act as the buil.derfor al.l. phases of construction. 2 . That the owner wi'll. compl.y with al.l. provisions of the City of Zephyrhil.l.s ordinances ~d codes pertinent to .the buil.ding. 3. That in the event various phases of construction are subcontracted, he wil.l. engage onl.y properl.y licensed subcontractors and wil.l. personal.l.y supervise such work. 4. That in the event the Buil.ding Inspector shal.l. require corrections to be made, the owner wil.l. assumeful.l. responsibil.ity to insure they are made, and upon compl.etionwil.l. cal.l. for a reinspection before proceeding with the buil.ding. 5. That the owner shal.l. assumeful.l. responsibil.ity :for the construction and wil.l. not expect supervision of his work :from the City of Zephyrhills Building Department. 6. That prior to final. inspection any additional. fees, incl.uding reinspection fees, must be paid inful.l.. A wr.i:tten request from this office shal.l. constitute an official. notice to pay additional. fees. 7. That the owner shal.l. compl.y withal.l. City, State and Federal. l.aws in regard to social. security, workman's compensation, l.ien l.aws, etc., where appl.icabl.e. 8. That the owner shal.l. compl.y with al.l. the safety codes issued by the Fl.orida Industrial. Commission. 9. State law requires construction to be done by l.icensed contractors. You have applied for a permit under an exemption to that l.aw. The exemption al.l.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 yoursel.f. You may buil.d or improve a one-famil.y or two-famil.y residence or a farm outbuil.ding. You may al.so buil.d or improve a commercial. buil.ding, provided your costs do not exceed $25,000. The buil.ding or residence must be for your own use or occupancy. It may not bebuil.t or substantial.l.yimproved for sal.e or l.ease. If you sel.l. or l.ease a buil.ding you have built or substantial.l.y improved yoursel.f wi thin 1 year after the construction is compl.ete, the l.aw will. presume that you buil.t or substantial.l.y improved if for sal.e or l.ease, which is a viol.ation of this exemption. You may not hire an unl.icensed person to act as your contractor or to supervise peopl.e working on your buil.ding. It is your responsibil.i ty to make sure that peopl.e empl.oyed by you have l.icenses required by state l.aw and by county or municipal. l.icensing ordinances. You may not del.egate the responsibil.ity for supervising work to a l.icensed contractor who is not l.icensed to perform the work being done. Any person working on your buil.ding who is not l.icensed must work under your direct supervision and must be empl.oyed by you, which means that you must deduct F.J:.C.A. and withhol.ding tax and provide workers' compensation for that empl.oyee, al.l. as prescribed by l.aw. Your construction must compl.y with al.l appl.icabl.e l.aws, ordinances, buil.ding codes, and zoning regu1..tions~~ =~~ OI; I-;f-!f;Z ,~FL ?M'l/J DATE 5/7/n PHONE gr? 7 7'1 ~.:).c, l{l r WITNESS PERMIT #