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\ I, \1IJl'.- agree to DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT { J " r 1'2- ~e{rf the provisions of this instrument. have read and:fu~~y understand and The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domici~e, that he or she actua~~y occupies, or wi~~ occupy by said domici~e, and same is not for rent, ~ease or sa~e. That he or she sha~~ comp~y with thefo~~owing conditions: ~. That the owner and he or she a~one sha~~ act as the bui~der ~or a~~ phases of construction. 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 ~icensed subcontractors and wi~~ persona~~y supervise such work. 4. That in the event the Bui~ding Inspector sha~~ require corrections to be made, the owner wi~~ assume :fu~~responsibi~ity to insure they are made, and upon comp~etion wi~~ ca~~ :for a reinspection before proceeding with the bui~ding. 5. That the owner sha~~ assumefu~~ responsibi~ity for the construction and wi~~ not expect supervision of his work :from the City of Zephyrhil1s Bui~ding Department. 6. That prior tofina~ inspection any additiona~ fees, inc~uding reinspection fees, must be paid in fu~~. A written request from this office sha~~ constitute an officia~ 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, ~ien ~aws, etc., where app~icab~e. 8. That the owner sha~~ comp~y wi th a~~ the safety codes issued by the F~orida Industria~ Commission. 9. State ~aw requires construction to be done by ~icensed contractors. You have app~ied for a permit under an exemption to that ~aw. The exemption al.~ows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a ~icense. You must provide direct onsite supervision of the construction yourse~f. You may bui~d or improve a one-fami~y or two-fami~y residence or a farm outbui~ding. You may a~so bui~d or improve a commercia~ bui~ding, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. It may not be bui~t or substantial.~y improved for sa~e or ~ease. If you se~~ or ~ease a bui~ding you have bui~t or substantia~~y improved yourse~f within 1 year after the construction is comp~ete, the ~aw wi~~ presume that you bui~t or substantia~~y improved if for sa~e or ~ease, which is a vio~ation of this exemption. You may not hire an un~icensed person to act as your contractor or to supervise peop~e working on your bui~ding. It is your responsibi~ity to make sure that peop~e emp~oyed by you have ~icenses required by state ~aw and by county or municipa~ ~icensing ordinances. You may not de~egate the responsibi~ity for supervising work to a ~icensed contractor who is not ~icensed to per:form the work being done. Any person working on your bui~ding who is not ~icensed must work under your direct supervision and must be emp~oyed by you, which means that you must deduct F.I.C.A. and withho~ding tax and provide workers' compensation for that emp~oyee, a~~ as prescribed by ~aw. Your construction must comp~y with a~~ app~icab~e ~aws, ordinances, bui~ding C ;~~ ~~~Jr~~:fif{d5 DATE 6,;9rY7 PHONE gl:j- 9q7-:J~ ~ 7 WITNESS PERMIT #