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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS EUILDINGDEPARTMENT 'I, :::r()II~ ~oINA have read and -fu~~y understand and agree to the provisions of this instrument. The undersigned states and affirms that he or she is desirous of constructing, xenovating, adding to or reroofing his or her own dom.ici~e,that he or she actual~y occupies, or wil~ occupy l:ly said dom.iciJ.e, and same is not for rent, .1.ease or sale. That he or she shalJ. comp~y with the .fo~~owing conditions: ~. That the olf-tler and he or she alone shaJ.:~ act as -the bui~der for al~ phases of construction. .That .the owner wi~~ compJ.,y with a.J.~ prov:is:ions of the City of Zephyrhi.~~s ordinances and codes pertinent to the bu.il.ding. That in the event various phases of construction engage onJ.y properl.y l.icensed subcontractors and such work. That in the event the Bu.ilding Inspector sha1.l. require corrections .to be made, the ownerw:il.l. assume fu1.l. respons:ibil.i ty to insure they are made, and upon compl.etion w:il.l. call. for a re:inspection before proceeding w:i th the bu.iJ.ding. That the owner sha1.l. assume fu1.l. respons:ibil.~ty for the construction and w:i~l. not expect supervision of his work from the City of Zephyrhi.l.~s Bui.J.ding Department. That prior to f:inal :inspection any additional. fees, incl.uding re:inspection fees, must be paid :in fu1.l.. A wr:i tten request from this office shall. constitute an official notice to pay additional. fees. That the owner shall. compl.y with all. C:i ty , State and Federal l.aws :in regard to social secur:ity, workman's compensation, l.ien ~aws, etc., where app~.icabJ.e. That the owner sha1.J.. compJ.y w:ith all. the safety codes issued by the FJ.orida Industrial Commission. State l.aw requires construction to be done by ~:icensed contractors. You have appl.ied for a permi. t under an exemption to that J.aw. The exemption all.ows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a l.icense. You must provide direct onsite supervision of the construction yoursel.f. You may bu.i~d or improve a one-fami.l.y or two-fam:il.y res:idence or a faxm outbu.iJ.ding. You may al.so bu.i~d or improve a commercial. bu.i~di.ng, provided your costs do not exceed $25,000. The bui.l.di.ng or res:idence must be for your own use or occupancy. It may not be bu.il.t or substantial.l.y .improved for sal.e or l.ease. If you se~~ or ~ease a buil.ding you have buil.t or substantial.l.y improved yourse~f within 1 year after the construction is compl.ete, the ~aw wi~l. presume that you buil.t or substantia.J.l.y improved if for sale or l.ease, which :is a viol.ation of this exemption. You may not hire an un1.icensed person to act as your contractor or to supervise peop~e work:ing on your bu.il.di.ng. It:is your respons:ibi~i ty to make sure that peop~e emp~oyed by you have ~icenses required by state l.aw and by county or municipal. ~icens:ing ordinances. You may not del.egate the respons:ibi~ity for superv:ising work to a l.icensed contractor who :is not ~ioensed to perform the work being done. Any person work:ing on your bui.l.ding who is not l.icensed must work under your direct supervision and must be emp~oyed by you, which means that you must deduct F.I.C.A. and withhol.ding tax and prov:ide workers' compensation for that emp~oyee, al.l. as prescr:ibed by l.aw. Your construction must compJ.y wi th al.~ app~icab~e ~aws, ordinances r bui.~ding codes, and zoning regul.a tions . OWNER'S SIGNATURE ~ ..zI~ ADDRESS "39 U J,t) t.Tf7iJ'..- ~ Z ~/11;~ M 'LL I PHONE 78"'1. - ~ 1/(, 2. 3. are subcontracted, he w:i~~ wi1.1.personal.~y supervise 4. 5. 6. 7. 8. 9. DATE q ft.7h7 . WITNESS PERM:I:Ti