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' DISCI,OSURE S'�'a'�'F*�*T'►' .FOR OW1�R CZTY OF ZEPx��TT?-S BVII.Da7G DEPARTt�NT _� _ have read arid fu11y tuiderstaad and agree to the provisions of �this instr�etit• The usidersigned .states and affirms that he or she is desirous of constructing, resiovating, adding to or reroofing his or her ov�n domicile, that he or she actually occupies, or �i11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she shall comply wi the following condi 1. Tlzat the owaer and_he or she aloae sha11 act as the bui.lder for a11 phases of construction. 2. That tlze owner wi11 comply with a11 provisions of �the City of Zephyrhills ordinances and codes perti.aent to the building. 3. That in the event various phases of construction are subcontracted, he will enga.ge only•propErly liceased subcontractors and will pErsonally supervise such work. 4. That in the event the Hui.ldiag Inspector sha11 require cortections to be made, the owner will assume fu11 responsiY�ility to iasuse�they are made, and upon completion wi11 ca13 for a rp� *+-�+�ction before proceeding wa.th the building. 5. That the owner sha11 assume full responsibility for the constructi.on and v�i11 not expect_ supervision of his work from the Ciiy of Zephyrhills Building Depar'�ent . 6. That prior to final inspection aszy additional fees, i.ncluding reinspection feas, must be paid in ful1. A written request from this office sha11 constitute an official notice to pay additional fees. 7. That the owner sha11 comply with a11 City, State and Federal laws ia regasd to social security, workman's compeasatioa, lien laovs, etc., where applicable. B. That the owner sha11 comply with a11 the safety codes issued by the Florida Industrial Commission. 9. State 1aw re?+ constsuction to be done by licensed contractors. You have applied for a�*�+++; t under an exemption to that law. The exemption allows 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 coastx�zetioa yovrself. You may build or improve a one-family or tmo-family residence or a fasm outbuildiag. You may also build or improve a commerci.al building, provided your costs do aot exceed $25,000. The building or residence must be for yovt own use or occupaacy. 2t may not be built or substaatially improved for sale or lease. If you sell or lease a build.isig you have built or substaatially ��proved yourse].f within 1 year after the constraction is complete, the 1aw will pres�e•that you built or subs imprcved •if for sale or laase, which is a violation of this exemption. You may aot hire an unliceased person to act as your contsactor or to supervise people warkiag on your building. It is your responsibility to make sure that people employed by you ha.ve liceases rec� by state law and by county or municipal licensing ordi.aances. You may not delegate the responsit�ility for supervising �vork to a licensed contractar who is not. licensed to pgrform �the �vork beiag dnne. As�.y p�rson working on your building who is not licensed must work uader your direct supervision and must be p�loyed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' compp�sation for that amploy�e, all as prescribed by law. Your coastruction must comply with a11 applicable laws, ordiaances, building codes, and zon.ing regulatioas. ,,/ � �`O�WNER' S SIGNATC7R,E �rf� �� /- /��L'� na�r*� ADDRESS PHONE � r � � b - - - � WTTNESS PEFtM2T #