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' DISCLOSURE S'�'n'►'�•*�'NT .FOR OWNER CITY OF ZEPHYRH2I:LS BVILD2NG DEPARTN�NT 2, � _ have read and fv11y understand and agree •to the provisions of �this instrum�t. The undersigned states and affirms that he or she is desirous of' constructing, renovating, add.ing to or reroofing his or her own domi.cile,•that he or she actually occupies, or 9vi11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she sha11 comply with the following condztions: 1. Ttiat the owner and_he or she alone sha11 act as the buil.der for a11 phases of constsuction . 2. That the owuer wa:11 comply with a11 provisions o£�the City of Zephyrhil'ls ordinances and codes pertinerit to the building. 3. That in t�ae avesit various phases of construction a=e subcontracted, he will engage only properly licansed subcontractors and will personally supervise such work. 4. That in the everit the Bui.ldiag 2nspector shall rez corractions to be made, - the owner will assume full responsiUility to insure•they are made, and upon completion wi11 call for a reiaspection before proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the consttt.iction aad wi11 not expect_ supervision of his a�ork from the City .of Zephyrhills Btiilding Dapartmexit . 6. That prior to final iaspection aay additional fees, including reinspection feas, must be paid ia ful1. A written request from this office sha11 constitute an official notice �to pay additioxia�. fees . 7. That the orovner sha11 comply with a11 City, State and Eederal laws in regard to social sacurity, worl�an's compensation, lien laws, etc., where applicable. B. That the owner sha11 compZy with a11 the safety codes issued by the Florida Industrial Commission. 9. 5tate 1aw re ��ir es constniction to be done by licensed contractors. You have applied for a�*-+++; t under an exemption to that law. The exP�ption allcws you, as the owner of your propesty, to act as your own contractor with cp*-+-=�T restsictioas evea though you do not ha.ve a license. You must provide direct onsite supervision o� the coastruction yours�. You may bvild or improve a one-family or two-family reside�,ce or a farm outbuildiag. You may also build or i.mprove a commercial building, provided your costs do not exceed $25,000. The building ar resideace must be for your own use or occupancy. It may not be built or substaati.ally improved for sale or lease. If you sell or lease a building you have built or substantially i�¢proved yourself within 1 year after the construction is complete, the law will presume•that you built or substantially improved•if for sale or laase, which is a violation of this exempt�.on. You may not hire an ualicensad pE='son to act as your contractor or to supervise people working on your buildixig. It is your responsibility to make sure that people employed by you hane liceases re�+ by sta.te law and by county or muziicipal licensing orclivaaces. You may not delegate the responsibility for supervising work to a liceased contractor who is not. 1ic�ns�d to perform the vvork beiag dnaa. Aay person working on your building who is aot licensed must work uncler your diract supervision axid must be employed by you, which means that you must deduct F.I.C.A. and vrit�holding tax and provide workers' compensatioa for that employee, a11 as prescribed by law. Your construction must comply with a11 applicable laws, ordinasces, building codes, and zoning regulations. OWt�R' S SIGNATLTRE / � � �- nn� Li...IZ. t/ ADDRESS �5"io �� PHONE - --�9 - Ls2J W=TNESS PERM2T #