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DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, Iall1A.es A - Zu....-Ilo have read and fully understand and agree to the provisions of this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domici1e, that he or she actua11y occupies, or wi11 occupy by said domici1e, and same is not for rent, 1ease or sa1e. That he or she sha11 comp1y with the fo11owing conditions: 1. That the owner and he or she a10ne sha11 act as the bui1der for a11 phases of construction. That the owner wi11 comp1y with a11 provisions of the City of Zephyrhi11s ordinances and codes pertinent to the bui1ding. That in the event various phases of construction are subcontracted, he wi11 engage on1y proper1y 1icensed subcontractors and wi11 persona11y supervise such work. That in the event the Bui1ding Inspector sha11 require corrections to be made, the owner wi11 assume fu11 responsibi1ity to insure they are made, and upon comp1etion wi11 ca11 for a reinspection before proceeding with the bui1ding. That the owner sha11 assume fu11 responsibi1ity for the construction and wi11 not expect supervision of his work from the City of Zephyrhi11s Bui1ding Department. That prior to fina1 inspection any additiona1 fees, inc1uding reinspection fees, must be paid in fu11. A written request from this office sha11 constitute an officia1 notice to pay additiona1 fees. That the owner sha11 comp1y with a11 City, State and Federa1 1aws in regard to socia1 security, workman's compensation, 1ien 1aws, etc., where app1icab1e. That the owner sha11 comp1y with a11 the safety codes issued by the F10rida Industria1 Commission. State 1aw requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption a1lows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourse1f. You may bui1d or improve a one-fami1y or two-fami1y residence or a farm outbui1ding. You may a1so bui1d or improve a commercial bui1ding, provided your costs do not exceed $25,000. The bui1ding or residence must be for your own use or occupancy. It may not be bui1t or substantia11y improved for sa1e or lease. If you se1l or 1ease a _bui1ding you have built or substantia11y improved yourse1f within 1 year after the construction is comp1ete, the 1aw wi11 presume that you built or substantia11y improved if for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise peop1e working on your building. It is your responsibility to make sure that peop1e employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your bui1ding who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers!\compensation for that employee, all as prescribed by 1aw. Your construction mu;t comp1y with a11 a p1icable laws, ordinances, bui1ding codes, and zoning!r~9u1ations. J . OWNER'S SIGNATURE l' I DATE .3 /~ / () 9 ADDRESS 345\ ;( -g +'- , , PHONE _(~13) 7'3'3-157"14- '~ b-slwir 2. 3. 4. 5. 6. 7. 8. 9. WITNESS PERHIT #