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• DISCLOSURE STA'�'F�•N'r .FOR OWI�R CITY OF ZEPHYRFiILS HIIII�DING DEPARTI�NT 2, •J o S � �P � OV I ' � i��''o have read and fully unders tand and agree to the provisions of •this instrumeri't • .The undersigned.sta.tes and affirms that he or she is desirous of constructing, renovating, adding to or reroofiag his or her o�n domicile, that he or she actually occupi�s, or wi11 occupy by said domiczle, and same is not for •rent, lease or sale. That he or she sha11 comply with the followiag conditions: 1. That the owner and lie or she alone shall act as the builder for a11 phases of construction. 2. That the owner wi11 comply with a11 p='ovisions of �the City of Zephyrhills ordi.nances and dodes pertiaent to the buildiag. 3. fihat in the event various phases of construction are subcontracted, he will en�aqe only�properly licensed subcontractors and will personally supervise such work. 4. TYiat in the evesit the Buildiag Inspector shall rezTire corrections to be made, - the owner wi11 assume full responsi]�ility to i.nsure •they are made, and upon completion �+ri11 ca1'1 for a re�n-�ction before proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the construction and o�i11 not expect_supervision of his wark from the City.of Zephyrhills Building Depastment. 6. That prior to fina.l inspection any additional fees, including reinspection fses, must be paid ia fu11. A�rittesi requast fram this office shall consti�tute an official notice - to pay additior�al fees . 7. That the owner sha11 comply with a11 City, Sta.te and Federal laws in regBrd to social security, workman's compensation, liea 1aws, etc., where applicable. @. That the owner shall comply with a11 the safety codes issued by the Florida Iadustrial C�+++� ssion. 9. State 1aw re� construction to be done by liceased contractors. You have applied for a permit under axi exemption to that law. The exemption allows you, as the owsier of your property, to act as your own contractor with cer+=;*+ restsictions even though you do not have a license. You must previde direct onsite supervision of the coastruct�.on yousself. You may build or improve a one-family or t�oo-fama.ly resid�ce or a fazm out�iuilding. You may also build or a.mprove a commercial building, provided yovr costs do aot exceed $25,D00. The buildi.ng or residsnce must be for yovs owsi use or occupancy. It may not be bvilt or substantially improved fcr sale or lease. If you sell or lease a building you have built or substantially improved yourself withz.n 1 year after the construction is complete, the 1aw wi.11 presume•that you built or substantially improved�if for sale or laase, which is a violation of this exemptiori. You may not hire an unlic�usad persoa to act as your contractor or to supervise people workiag on your building. 2t is your responsibility to make sure tha.t people employed by you have licenses rec� by state law and by county or municipal liceasing ordinances. You may not delegate the responsibility for supervisi.ng work to a licensed contrdctor who is not. licensad to perform the mork being done. AnX parson workixig on yous building who is aot licansed 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' compeasatioa for ttiat amployee, a11 as prescribad by law. Your cons�txziction must comply with a11 applicable laws , O=�� T�� , building codes, aad zoning regul�ions. � ' " � owr�R� s sz�� ;� .�_.-1�--- �'«; l� � n� 1,�' - �S- / o �DxESS 3�G 3 d $_.,� t�, �� '� �r� rr ti� (� s, �l a 3��iZ. Pxorr� sf / 3- 3 i�3 -�� 9 g W2TNESS I.(�,��-. %� � �i?►�?'T #