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<br />'DISCLOSURESTATEMENT'FOR OWNER <br />CITY OF .2EPHYRHILLS.:.... .BUILDING DEPARTMENT <br /> <br />11 ~. ~S:..C51' <br />provisions of this instrument. <br /> <br />have read and fully understand and agree to the <br /> <br />The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or <br />reroofing his or her own domicile, that he or she actually occupies, or will occupy by said <br />domicile, and same is not for rent, lease or sale. That he or she shall comply with the following <br />conditions: <br /> <br />1. Thatthe owner and he or she alone shall act as the builder for all phases of construction. <br />2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes <br />pertinent to the building. <br />3. That in the event various phases of construction are subcontracted, he will engage only <br />properly licensed subcontractors and will personally supervise such work. <br />4. That in the event the Building Inspector shall require corrections to be made, the owner will <br />assume full responsibility to insure they are made, and upon completion will call for a <br />reinspection before proceeding with the building. <br />5. That the owner shall assume full responsibility for the construction and will not expect <br />supervision of his work from the City of Zephyrhills Building Department. <br />6. That prior to final inspection any additional fees, including reinspection fees, must be paid in <br />full. A written request from this office shall constitute an official notice to pay additional fees. <br />7. That the owner shall comply with all City, State and Federal laws in regard to social security, <br />workman's compensation, lien laws, etc., where applicable. <br />8. That the owner shall comply with all the safety codes issued by the Florida Industrial <br />Commission. <br />9. State law requires construction to be done by licensed contractors. You have applied for a <br />permit under an exemption to that law. The exemption allows you, as the owner of your <br />property, to act as your own contractor with certain restrictions even though you do not have <br />a license. You must provide direct onsite supervision of the construction yourself. You may <br />build or improve a one-family or two-family residence or a farm outbuilding. You may also <br />build or improve a commercial building, provided your costs do not exceed $75,000. The <br />building or residence must be for your own use or occupancy. It may not be built or <br />substantially improved if for sale or lease, which is a violation of this exemption. You may not <br />hire an unlicensed person to act as your contractor or to supervise people working on your <br />building. It is your responsibility to make sure that people employed by you have licenses <br />required by state law and by county or municipal licensing ordinances. You may notdelegate <br />the responsibility for supervising work to a licensed contractor who is not licensed to perform <br />the work being done. Any person working on your building who is not licensed must work <br />under your direct supervision and must be employed by you, which means that you must <br />deduct F.I.CA and withholding tax and provide work~r's compensation for that employee, all <br />as prescribed by law. Y r construction must comply with all applicable laws, ordinances, <br />building codes, and zo In regulation. <br /> <br /> <br />DATE <br /> <br />~./r-(}~ <br /> <br />OWNER'S SIGNATUR <br />ADDRESS <br />PHONE <br /> <br />WITNESS <br /> <br />PERMIT <br /> <br />I/MastcIforms/OwnersAffidavitINov07 <br />