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<br />DISCLOSURE STATEMENT FOR OWNER <br />CITY OF ZEPHYRHILLSBUILDING DEPARTMENT <br />-. , <br /> <br />I,j);allll€, 1/\('ldbrl\Jffi have read and -fu1.1.y understand and <br />ag~ee to the provisions of .s instrument. <br /> <br />The undersigned states and affirms that he or she is desirous of constructing, <br />renovating, adding to or reroofing his or her own domici1.e, that he or she <br />actua1.1.y occupies, or wi1.1. occupy by said domici1.e, and same is not for <br />rent, .1.ease or sa1.e . That he or she sha1.1 comp1.y with thef o1.1.owing conditions: <br /> <br />1. <br /> <br />That the owner and he or she al.one sha1.1. act as the bui1.der for a1.1. phases of <br />construction. <br />That the owner wi1.1. comp1.y with a1.1. provisions of the City of Zephyrhi1.1s <br />ordinances and codes pertinent to the bui1.ding. <br />That in the event various phases of construction are subcontracted, he wi11. <br />engage on1.y proper1.y 1.icensed subcontractors and wi1.1.personal.1.y supervise <br />such work. <br />That in the event the Bui1.ding Inspector sha1.1. require corrections to be made, <br />the owner wi1.1. assume fuJ.1. responsibi1.i ty to insure they are made, and upon <br />comp1.etion wi1.1. ca1.1. for a reinspection before proceeding with the bui1.ding. <br />That the owner sha1.1. assume fuJ.1. responsibi1.ity for the construction and wi1.1. <br />not expect supervision of his work from the City of Zephyrhi1.1.s Bui1.ding <br />Department. <br />That prior to final. inspection any additiona1. fees, inc1.uding reinspection <br />fees, must be paid in fu1.1.. A written request from this office sha1.1. <br />constitute an official. notice to pay additiona1. fees. <br />That the owner sha1.1. comp1.y with al.1. City, State and Federa1. 1.aws in regard to <br />social. security, workman's compensation, 1.ien 1.aws, etc., where app1.icab1.e. <br />That the owner sha1.1. comp1.y with a1.1. the safety codes issued by the F1.orida <br />Industrial. Commission. <br />State 1aw requires construction to be done by 1.icensed contractors. You have <br />app1.ied for a permit under an exemption to that 1.aw. The exemption al.1.ows <br />you, as the owner of your property, to act as your own contractor with certain <br />restrictions even though you do not have a 1.icense. You must provide direct <br />onsite supervision of the construction yourse1.f. You may bui1.d or improve a <br />one-fami1.y or two-fami1.y residence or a farm outbui1.ding. You may a1.so bui1.d <br />or improve a commercia1. bui1.ding, provided your costs do not exceed $25,000. <br />The bui1.ding or residence must be for your own use or occupancy. It may not <br />be bui1.t or substantia1.1.y improved for sal.e or 1.ease. If you se1.1 or 1.ease a <br />bui1.ding you have bui1.t or substantial.1.y improved yourse1.f within 1 year after <br />the construction is comp1.ete, the 1.aw wi1.1. presume that you bui1.t or <br />substantia1.1.y improved if for sa1.e or 1ease, which is a vio1.ation of this <br />exemption. You may not hire an un1.icensed person to act as your contractor or <br />to supervise peop1.e working on your bui1.ding. It is your responsibi1.ity to <br />make sure that peop1.e emp1.oyed by you have 1.icenses required by state 1.aw and <br />by county or municipa1. 1.icensing ordinances. You may not de1.egate the <br />responsibi1.ity for supervising work to a 1.icensed contractor who is not <br />1.icensed to perform the work being done. Any person working on your bui1.ding <br />who is not 1.icensed must work under your direct supervision and must be <br />emp1.oyed by you, which means that you must deduct F.I.C.A. and withho1.ding tax <br />and provide workers' compensation for that emp1.oyee, al.1. as prescribed by 1.aw. <br />Your construction must comp1.y with a1.1 app1icab1e 1aws, ordinances, bui1.ding <br />codes, and zoning regu1.ations. .j <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br />6. <br /> <br />7. <br /> <br />8. <br /> <br />9. <br /> <br />OWNER'S <br />ADDRESS <br />PHONE <br /> <br /> <br />lLJ/I [)-0' <br /> <br />/ <br /> <br />) <br /> <br />DATE <br /> <br />PERMIT # <br /> <br />WITNESS <br />