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• DISCLOSIIRE S'�'n'�'*�•� .FOR OW1�R CZTY OF ZEPHYREi=I�LS BUII.DSNG DEPaQ'�'►�•NT = have read arid f'u11y understand and , agrae to the provisions of �this insttument• The undersigned states and affirms that he or she is desirous of constructing, rgnovating, adding to or reroofiag his or her own domicile,•that he or she actually occupies, or wi11 occupy by said domici:le, and same is not for •rent, lease or sale. That he or she sha11 comply with the following conditions: 1. Tlzat the owner aad he or she alone sha11 act as the bvilder for a11 phases of construction. 2. That the owner wi:11 comply with al]: provisions of �the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction are subcoatracted, he will engage orily•propesly licensed subcontractors and will persosially supervise such work. 4. That in the event the Huilding Inspector shall rec� corrections to be made, the owner will assume full responsil�ility �to isisure •they ase made, and upon completion wi11 call for a re;*+�ectioa before proceeding with the builciYng. 5. That the owner sha11 assume fu11 responsibility for the construction and wi11 not expect_supervisioa of his mork from the City of Zephyrhil'ls Building Depast��t . 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in fu11. A written request from this office sha11 constitute an official notice pay add.itional fees. 7. That the owner sha11 comply vrith a11 City, State arid Fedesal laws iri regard to social security, workman's compensation, lien laws, etc., wYiere applicable. 8. That the owner sha11 comply with al1 the safety codes issued by the Floricia Iridustrial Commission. 9. State 1aw requlx'es constrLiction to be done by licensed contractors. You have applied for a per+��t under an exe�ption to t�iat law. The exemption allows you, as the owner of your property, to act as yovr own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision o�' the constructiori yourself. You may build or improve a one-family or two-family residence or a faim outbuilding. You may also build or improve a commercial building, provided yovr costs do not exceed $25,000. The building or residence must be for your own use or occupancy. St may not be built or substantially improved for sale or lease. If you se]:1 or lease a bvilding you have built or substzntially improved yourself withia 1 year after the constniction is complete, the law will pres�e�that you built or substantially improved if for sale or lease, which is a violation of this EX e�pti.on. You may not hire an unlicensed pE='son to act as yovr coatsactor or to supervise people working on your building. 2t is yovr responsibility to make svre that people employed by you have licenses rec� by state law and by county or municipal licensing ordinances. You may not delegate the respoasibility for supervising work to a licensed contractor who is not. licensed to perform the worlc being doa�. AnX pESSOn working on yovr btsilding who is not licensed must work uader your dirac�t supervision and must be P�ployed by you, which maaas that you must deduct F.I.C.A. and withtiolding taa and provide worlcers' co for that employee, a11 as prescribed by law. Your construction must comply with a11 applicable 1aws, ordinances, building codes, and zoning ragulations. ,� �/"" OWNER' s s2GNATURE i'"'L! , l�v"' �• p' nnR*F: ADDRESS PHONE W2TNESS PERMLT #