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DISCLOSURE STATEMENT FOR OWNER _ CITY OF ZEPHYRHILLS BUILDING -DEPARTMENT I,~~~\ S~c agree to the provisions of this instrument. have read and -.fu1.1.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 domici1.e ,that he or she actuaJ.1.y occupies, or wi~1. occupy l:?Y said domici1.e, and same is not for rent, .1.ease or saJ.e. That he or she shaJ.:l com.p1.y with the fo1.1.owing conditions: -.1. That the o"!'Iler and he or she a:J.one shcU:l act as i:he bui1.derfor aJ.1. phases of construction. That -the owner wil.l. compJ,y wi-th al.1. provisions of the City of Zephyrhil.l.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 willpersona1.1.y supervise such work. That in the event the BuiJ..ding Inspector shaJ.1. require corrections -to be made, the owner .wi1.l. assume ful.l. responsibil.i ty to insure they are made, and upon compl.etion wi1.1. cal.1. for a reinspection before proceeding with the bu:il.ding. That the owner sha1.1. assume ful.1. responsibi1.:ity for the construction and wi1.1. not expect supervision of his work from the City of Zephyrh:i1.1.s Bu:i:lding Department. . That prior to finaJ. inspection any addi tionaJ. fees, inc1.uding reinspection fees, must be paid in ful.1.. A written request from this office shaJ.1. consti tute an officiaJ. notice to pay additional. fees. That the owner shaJ.1. com.p1.y with aJ.1. City, State and Federa1. 1.aws in regard to sociaJ. security, workman's compensation, 1.ien 1.aws, etc., where app1.icab1.e. That the owner shaJ.:l- com.p1.y with aJ.1. the safety codes issued by the F1.orida IndustriaJ. 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 :law. The exemption aJ.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 yourse:lf. You may bu:i1.d or improve a one-fami1.y or two-fami1.y residence or a farm outbu:i1.ding. You may aJ.so bu:i1.d or improve a commercial. bu:i1.ding, provided your costs do not exceed $25,000. The bu:i1.d:ing or residence must be for your own use or oc=pancy. It may not be bui1. t or substantiaJ.1.y improved for saJ.e or 1.ease. If you se1.1. or 1.ease a bui1.ding you have bui1. t or substantiaJ.1.y improved yourse1.f wi thin 1. year after the construction is com.p1.ete, the 1.aw wi1.1. presume that you bui1.t or substantiaJ.1.y improved if for saJ.e or 1.ease, which is a vio1.ation of this exemption. You may not hire an un1.icensed person to act as your contractor or to supervise peop1.e working on your bui1.ding. It is your responsibi1.i ty to make sure that peop1.e emp1.oyed by you have 1.icenses required by state 1.aw and by county or municipaJ. 1.icensing ordinances. You may not de1.egate the responsibi1.ity for supervising work to a 1.icensed contractor who is not 1.icensed to perfo=. the work being done. Any person working on your bui1.ding who is not l.icensed must work under your direct supervision and must be emp1.oyed by you, which means that you must deduct F.I.C.A. and withho1.ding tax$and provide workers' compensation for that emp1.oyee, aJ.1. as prescribed by 1.aw. Your construction must com:p1.y with al.1. app1.icab:le 1.aws, ordinances, bu:i1.ding codes, and ZOning~re~gu1.at:i~' ons. / OWNER'S SIGNATURE . .~ ~ ADDRESS ~~~~ - ~;:Pi>h~~q\)--::L~ ~~5-L.(d- PHONE e \ 'A - '+ ~<-t ~ ~<C 1'8 '1. 2. 3. 4. 5. 6. 7. 8. 9. " ~ d-- 'f - JJ-001 WITNESS PERMIT #