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<br />'DISCLOSURE'STATEMENTfFOROWNER <br />CITY OF.ZEPHYRHILLS.:"<BUILDING DEPARTMENT <br /> <br />(! OA"'L-LW;. ~~ <br />provisions of this i strument. . <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 />have read and -fully understandand.agree to the <br /> <br />. . <br />1. ThaUhe owner and he or she alone shall act as the builder"for all phases of construction. <br />2. Thatthe.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 'fullresponsibility 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 on&-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 not delegate <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.C.A. and withholding tax and provide worker's compensation for that employee, all <br />as prescribed by law. Your construction must compiy with all applicable laws, ordinances, <br />building codes, and zoning regulations. <br /> <br />. . . <br /> <br />OWNER'S SIGNAj"URE (/ A I<. L"-1~e.. . DATE l-\ J 1'71e><.( . <br />ADDRESS 45~~:5e.o+u:r~ ~ () \l\S: Fl 3a54 ~ I .... <br />PHONE J ~- ~ "J- - J.., l . ... .. . <br /> <br />WITNESS <br /> <br />PERMIT <br /> <br />IIMaster.fonnslOwnersA:ffidavitlNov07 <br />