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DISCLOSURE STATEMENT FOR OWNER <br /> CITY OF ZEPHYRHILLS BUILDING DEPARTMENT <br /> I, � C. � have read and fully understand and <br /> agree o the provisions of this instrument. <br /> The undersigned states and affirms that he or she is desirous of constructing, <br /> renovating, adding to or reroofing his or her own domicile, that he or she <br /> actually occupies, or will occupy by said domicile, and same is not for <br /> rent, lease or sale. That he or she shall comply with the following conditions: <br /> 1. That the owner and he or she alone shall act as the builder for all phases of <br /> construction. <br /> 2. That the owner will comply with all provisions of the City of Zephyrhills <br /> ordinances and codes pertinent to the building. <br /> 3. That in the event various phases of construction are subcontracted, he will <br /> engage only properly licensed subcontractors and will personally supervise <br /> such work. <br /> 9. That in the event the Building Inspector shall require corrections to be made, <br /> the owner will assume full responsibility to insure they are made, and upon <br /> completion will call £or a reinspection before proceeding with the buildi.ng. <br /> 5. That the owner shall assume full responsibility for the construction and will <br /> not expect supervision of his work £rom the City of Zephyrhills Building <br /> Department. <br /> 6. That prior to f'inal inspection any additional f'ees, including reinspection <br /> £ees, must be paid in full. A written request from this off'ice shall <br /> 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 <br /> social security, workman's compensation, lien laws, etc., where applicable. <br /> 8. That the owner shall comply with all the safety codes issued by the Florida <br /> Industrial Commission. <br /> 9. State law requires construction to be done by licensed contractors. You have <br /> applied for a permit under an exemption to that law. The exemption allows <br /> you, as the owner of your property, to act as your own contractor with certain <br /> restrictions even though you do not have a license. You must provide direct <br /> onsite supervision o£ the construction yourself. You may build or improve a <br /> one-family or two-family residence or a farm outbuilding. You may also build <br /> or improve a commercial building, provided your costs do not exceed $25,000. <br /> The building or residence must be for your own use or occupancy. It may not <br /> be built or substantially improved Por sale or lease. If you sell or lease a <br /> building you have built or substantially improved yourself within 1 year after <br /> the construction is complete, the law will presume that you built or <br /> substantially improved if for sale or lease, which is a violation o£ this <br /> exemption. You may not hire an unlicensed person to act as your contractor or <br /> to supervise people working on your building. It is your responsibility to <br /> make sure that people employed by you have licenses required by state law and <br /> by county or municipal licensing ordinances. You may not delegate the <br /> responsibility for supervising work to a licensed contractor who is not <br /> licensed to per£orm the work being done. Any person working on your building <br /> who is not licensed must work under your direct supervision and must be <br /> employed by you, which means that you must deduct F.I.C.A. and withholding tax <br /> and provide workers' compensation for that employee, all as prescribed by law. <br /> Your construction must comply with all applicable laws, ordinances, building <br /> codes, and zoning re lations. <br /> OWNER' S S I ATITRE � ti( DATE c� .°� � �� <br /> ADDRESS • a, <br /> PHONE � . <br /> WITNESS PEELMIT # <br />