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� • DISCLOSURE S'rn'►'F'*�r�:NT .FOR OW1�R CITY OF ,ZEP II�ZS BIIII�DII�7G DEPAR'1R�NT = have read and fully understand and agree • the provisions of �this instrtsment • .The undersigned.states and affirms that he or she is desirous of constructing, renonating, adding to or reroofing his or her own dom.icile,•that he or she actual.ly occupies, or wi11 occupy by said dom.icile, and same is not for •rent, lease or sale. That he or she shall comply with the following conditions: 1. That the ovTner aad � he or she alone sha11 act as the bu.i].der for all phases of const-sucti on . 2. That the owrier will comply with a11 provisions of the City of Zephyrhills ordirlances and dodes pertineat to the building. 3. That in the event various phases of construction are subcontracted, he will engage ozily pr OFleL� ly licensed subcontractors and will persoaally supervise such work. 4. That in the eveat the Building Inspector sha11 reiT�'Te corrections to be made, the owner will assume fu11 responsibility to insure•they are made, and upon completion will ca13 for a reinspection before proceeding with the building. 5. T2iat the owner sha11 assume fu11 responsi.bility for the constrLiction and wi11 not expect_suppsvision of his work from the City of Zephyrhills Building Department. 6. That prior to final iaspection any addi.tional fees, including reinspection feas, must be paid in full. A writtea requast from this office sha11 constitute an official aotice - to pa.y adcL�.tioual fees . . 7. That the owner sha11 comply with al1 City, State and Federal laws in regard to soca.al security, workman's compensation, lien laws, etc., where applicable. 8. That the owner sha11 comply with all the safety codes issued by the Florida Industrial C��ssion. 9. State 1aw rec� construction to be done by licensed aontractors. You have applied for a�*T+; t under an ex�ption to that law. The exemption allows you, as the owner of your property, to act as your own contsactor with certai.n restrictions even though you do not ha.ve a license. You must_provide direct onsite supervision of the corist yoursel£. You may build or improve a one-family or two-family resideace or a farm outbuilding. You may also build or improve a commerci.al building, provided your costs do not �xceed $25,000. The building or residence must be for yovr own use or occupancy. 2t may not be built or substazitially i.mproved for sale or lease. If you sell or lease a building you have built or substantially improved yourself wit�in 1 year aftEr the constructioa is complete, the lam wi11 presume•that you.built or substanti.ally improved if for sale or lease, which is a violation of this exempti.on. You may not hire an ualicerased person tc act as yovr contractor or to supervise people working on your building. It is your responsibili:ty to make sure that people employad by you have liceases re? by state law and by county or municipal liceasiag ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not. licensed to perform the work being dosie. Any parson workiag on yous building who is not licensed must work undes yovr direct supervision and must be employed by you, which means that you must deduct E.I.C.A. and withholding tax and provide workers' compensatioa for that employee, a11 as prescri.bed by law. Your construction must comply with a11 applicable 1aws, ord3siances, building codes, and zoning regulations. OWNER' S S2GNA � �� DATE �� - � ` _ � !f .�DxESS �D Pr ,tr , ZL. s. �t,, 3 �.5 � � PHONE L7 W2TNES5 PERMIT #