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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ,II \ ) I \01 I, ,/J/(r..Jc .NO?ftx..)/.AJ have read andfu~~y understand and agree to the provis1ons of this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding ~ or reroofing hi~her own domicile, that he orahe actua~~y occupies, or wi~~ occupy by . / 07 said domici~e, and same is not for rent, lease or sa~e. That he or she s a~~ comp~y with the fo~~owing conditions: 1. That the owner and he or shea~one sha~~ act as the bui~derfor 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 licensed 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~~ assumefu~~ responsibi~i ty 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~~ assumeful:l responsibility for the construction and wi~~ not expect supervision of his work from the City of Zephyrhills Bui~ding Department. 6. That prior to final 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 shal.~ comp~y witha~~ City, State and Federa~ laws in regard to socia~ security, workman's compensation, lien ~aws, etc., where app~icab~e. 8. That the owner shal.~ comp~y wi th a~~ the safety codes issued by the F~orida Industria~ Commission. 9. State law requires construction to be done by ~icensed contractors. You have applied 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 license. You must provide direct onsite supervision of the construction yourse~f. You may bui~d or improve a one-fami~y or two-family residence or a farm outbui~ding. You may a~so bui~d or improve a commercia~ bui~ding, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. It may not be built or substantial.~y improved for sa~e or ~ease. If you se~~ or ~ease a bui~ding you have built or substantia~ly improved yourse~f wi thin 1 year after the construction is comp~ete, the law wi~~ presume that you bui~t or substantia~~y improved if for sa~e or ~ease, which is a vio~ation of this exemption. You may not hire an un~icensed person to act as your contractor or to supervise peop~e working on your bui~ding. It is your responsibi~ity to make sure that peop~e emp~oyed by you have ~icenses required by state law and by county or municipa~ ~icensing ordinances. You may not de~egate the responsibi~ity for supervising work to a ~icensed contractor who is not ~icensed to perform the work being done. Any person working on your bui~ding who is not ~icensed must work under your direct supervision and must be emp~oyed by you, which means that you must deduct F.I.C.A. and withho~ding tax and provide workers' compensation for that emp~oyee, a~~ as prescribed by ~aw. Your construction must comp~y with a~~ app~icab~e ~aws, ordinances, bui~ding :::: S :~;:;/ 7$~ DATE ~6/0/ :~:SS to~~ ~;}f~J'ft~ ~iJ~, ~AlN \]2?PSt CA 9s-IJ-S- WITNESS PERMIT #