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' DISCLOSIIRE S'►'a'►'F*�•*?'►' .FOR OWNER CSTY OF ZEPHYRHSIS�S BII�DSNG DEPARTD�NT Z, ' _ have raad and fully understarld and agree to the provisions of �this instrt�ent. The undersigned.states and affirms that he or she is desisous of constructing, renovating, adding to or seroofing his or hes o�an domicile, that he or she actually oceupies, or wi11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she sha11 comply wirth the follo�+ring conditions: 1_ That the owaer and.he or she alosie sha11 act as the builder for al1 phases of construction. 2. That the owner wi1.1 comply with al1 provisions of the City of Zephyrhills orclinances and codes pertinent to the building. 3. That in the event various phases of construction are subcontracted, he will engage only•prOpPS1y licensed subcontsactors and will personally supervise such work. 4. Z'izat in the even�t the Building Inspector sha11 rec� *-e corrections to be made, the owner wi11 assnme full responsi2�ility to iasure•they are made, and upon completion wi11 ca13 for a re;�+�etioa before proceeditig with the building. 5. That the owner sha11 assume fu11 responsibility for the coastruction aad vPi11 not expect_supervisioa of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspeotioa fees, must be paid in fu11. A written request from this office sha11 constitute an official notice - to pay additional fees. 7- That the owner sha11 comply wit� a11 City, State and Federal laws in regard to social secvrity, workmari� s c�+��*+�ation, lien laws, etc. , where applicable. B. That the owner sha11 comply with all the safety codes issued by the Florida Industrial Co�ission. 9. 5tate 1aw re rn�ir es construction to be done by licansed contractors. You have applied for a permit under an exempti,on to that law. The exemption allows you, as the owner of your prcperty, tc act as yous own contractor with certain restrictions even though you do not have a license. You must direct onsite supervision of the coastruction yourself. You may build or improve a one-family or two-family residence or a fa� outbuildi.ng. You may also build or improve a commercial buildi.ag, provided yovr costs do aot exceed $25,OOa. Z'he building or residaace must be for your own use or occupasicy. 2t may not be built or substanti i,�p=oved for sale or lease. If you sel:l or lease a building you have built or substantially improved yourself withi.n 1 yeas after the construction is complete, the la�v wi11 pres�e.that you built or substantially ,i„mproved •if for sale ar laase, which is a violation of this e�cemption. You may aot hire an ua],iceas�d person to act as yovs contractor or to supervise people workiag on your �+ It is your respoasibility to make sure that people employed by you have liceases ree+ by state law and by county or m liceasing ordiaances. You may aot delegate the responsibility for supervising work to a liceased contr-dctor who is not. licensed to perform thh� �vor7c beiag dozie. Axiy pez"'son working on yovs buildiiig who is not liceused must work Lmcler yous direct supexzrisioa and must be employed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' com�Tsation for that employee, a11 as prescribed by law. Your construction must comply oci 1 a licable 1aws, ordisiances, building codes, and zoning re o owxER� s szc�� nnm� ' .�1 / � ADDRESS _, PHONE S�T2TNESS PERM2T #