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'DISCLOSURE "ST ATEMENTFOR,OWNER CITY OF.ZEPHYRHILLS.:.....,BUILDfNG DEPARTMENT I, ~ 1f',({6 V &t:tMave read ~nd iully understand and.agree to the provisions of thl instrument. . 'The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile,'thathe or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following conditions: , . '1. That.the owner and he or she alone shall act as the builderfor all phases of construction. ' 2. That the' oWner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in' the event'the Building Inspector shall require corrections to be made, the owner will assume 'fullresponsibiUty to insure they are made" and upon completion will call for a reinspectionbefore proceeding with the, building. , 5. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, .lien laws, etc., where c:lpplicable. ,8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission.. ' . 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that. law. The exemption allows you, as the owner of your property, to act as YOl:lr own contractor with certain restrictions even though you do not have a license. You must provi.de direct onsitesupervision of the construction yourself. You may build or improve a one-,family or two-family residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do 'not exceed $75,000. The building or residence 'must.be for your own 'use or occupancy.' It may not be built or SUbstantially 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. people working on your building. It is your responsibility to make sure that people 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 building who is not licensed must work under your direct supervision and must be employed by you, which means that .you must deduct F.I.CA and withholding taxandprovidework~r's compensation for that employee, all as prescribed by law. ' Your construction must comply withal! applicable laws, .ordinances, building codes, and zoningr.egulations. . DATE 0/ '1-/67; . OWNER'S SIGNATURE ADDRESS PHONE, WITNESS PERMIT ,.' IIMasterforms/Ownc:rsAffidavitlNov07