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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, --.B I\Ki~A12 A 6. H F l€.J2..J'n ~ have read and fu1.1.y understand and agree to the provisions of this i strument. The undersigned states and affirms that he or she is desirous of constructing, renovating, a~ng to or reroofing his or her own domici1.e, that he or she actua1.1.~cup~;; or wi 1. 1. occupy by said, domici1.e, and, same is. nc:'t for rent, 1.ea V~ 'Ie. That he or she sha1.1. comp1.y w~th the fo1.1.ow~ng condit~ons: 1. That the owner and he or she a1.one sha1.1. act as the bui1.der for a1.1. phases of construction. That the owner wi1.1. comp1.y with a1.1. provisions of the City of Zephyrhi1.1.s ordinances and codes pertinent to the bui1.ding. That in the event various phases of construction are subcontracted, he wi1.1. engage on1.y proper1.y 1.icensed subcontractors and wi1.1 persona1.1.y supervise such work. That in the event the Bui1.ding Inspector sha1.1. require corrections to be made, the owner wi1.1. assume fu1.1. responsibi1.ity to insure they are made, and upon comp1.etion wi1.1. ca1.1. for a reinspection before proceeding with the bui1.ding. That the owner sha1.1. assume fu1.1. responsibi1.ity for the construction and wi1.1. not expect supervision of his work from the City of Zephyrhi1.1.s Bui1.ding Departmen t . That prior to fina1. inspection any additiona1. fees, inc1.uding reinspection fees, must be paid in fu1.1.. A written request from this office sha1.1. constitute an officia1. notice to pay additiona1. fees. That the owner sha1.1. comp1.y with a1.1. City, State and Federa1. 1.aws in regard to socia1. security, workman's compensation, 1.ien 1.aws, etc., where app1.icab1.e. That the owner sha1.1. comp1.y with a1.1. the safety codes issued by the F1.oricia Industria1. Commission. State 1.aw requires construction to be done by 1.icensed contractors. You have app1.ied for a permit under an exemption to that 1.aw. The exemption a1.1.ows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a 1.icense. You must provide direct onsite supervision of the construction yourse1.f. You may bui1.d or improve a one-fami1.y or two-fami1.y residence or a farm outbui1.ding. You may a1.so bui1.d or improve a commercia1. bui1.ding, provided your costs do not exceed $25,000. The bui1.ding or residence must be for your own use or occupancy. It may not be bui1.t or substantia1.1.y improved for sa1.e or 1.ease. If you se1.1. or 1.ease a bui1.ding you have bui1.t or substantia1.1.y improved yourse1.f within 1. year after the construction is comp1.ete, the 1.aw wi 1. 1. presume that you bui1.t or substantia1.1.y improved if for sa1.e or 1.ease, which is a vio1.ation of this exemption. You may not hire an un1.icensed person to act as your contractor or to supervise peop1.e working on your bui1.ding. It is your responsibi1.ity to make sure that peop1.e emp1.oyed by you have 1.icenses required by state 1.aw and by county or municipa1. 1.icensing ordinances. You may not de1.egate the responsibi1.ity for supervising work to a 1.icensed contractor who is not 1.icensed to perform the work being done. Any person working on your bui1.ding who is not 1.icensed must work under your direct supervision and must be emp1.oyed by you, which means that you must deduct F. I. C . A. and wi thho1.ding tax and provide workers' compensation for that emp1.oyee, a1.1. as prescribed by 1.aw. Your construction must comp1.y with a1.1. app1.icab1.e 1.aws, ordinances, bui1.ding codes, and zoning regu~tions. OWNER'S SIGNATURE ,,' y~,",~ ~tiGi>l ADDRESS bfj)~ 5 ---of/] . ~ PHONE B-1.?> - ,~55 -- I ~ (; '...., *1LWj- DATE qlJ1l07 2. 3. 4. 5. 6. 7. 8. 9. WITNESS PERMIT #