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• , DISCLOSiJRE S'�'a'►'F•*�•NT .FOR OWI�R CITY OF ZEPHYf2Fi22+I+S BVII�ING DEPAR'►'�•NT 2� ` J�C�� T� ��`(_�� have read and fu11y uxiderstand and agree •to the provisions of �this instrument• .The undersigned states and affirms that he or she is desirous of constsucting, renovating, adciing to or reroofing 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 shall comply with the following condi.tioas: 1. Z'ha.t the owner aad.he or she alone sha11 act as the buil.der for a11 phases of constrnction. � 2. That the owaer wi11 comply with a1:1 provisions of �the City of Zephyrhills ordinances and codes �*-t;nent to the buildiag. 3. That in the event vasious pha.ses of construction ase subcontracted, he will engage only •properly licaased subcontractors and will personally supervise such work. 4. That in the event the Building Inspector sha11 rec�T�Te corrections to be made, the oamer wi11 assume full responsibility 'to insure •they ase made, and upon completion will ca11 for a reinspectioa before proceeding with the building. 5. That the owner sha11 assUme fu11 responsibility for the construction and wi11 not expect_ supervision of his work from the Cif.y .of Zephyrhills Building Department. 6. Ttsat prior to final inspection any additl.onal fees, including reiaspection feas, must be paid ia full. A written raquast from this off'ice sha11 constitute an official notice -to pay additional fess. _ 7. That the owner shall comply with a11 City, 5tate and Federal laws in regard to social securi'�y, warkmari's compensation, lien laws, etc. , where applicable. 8. That the owner shall comply with a11 the safety codes issued by the Elorida Iadustrial C�+�+*+�ssion. 9. State 1aw rec�,;res construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption all�ws you, as the owner of yovr proppsty, to act as your owa contractor Frith eP*-+�a�*+ restrictions evea though you do not have a license. You must .provide direct onsite supervision o� the construction yovsself. You may build or i�prove 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 exceed $25,000. The building cr r�sideace must be for yovr o�an use or occupancy. It may not be built or substautially i�proved for sale or lease. If you sell or lease a building you have built or substaritially improved yourself within 1 year after the constsuction is complete, the law wi11 pres�e •t�at you built or substantially i.mproved if for sale or lease, which is a violation of this exemption. You may not hire aa unlicensad person to act as your contractor or to supervise people working on your buildiag. It is your responsibility to make sure that people employed by you hane liceases re?,;red by state law and by county or mun.icipal licensiag ordiaances. You may not delegate the responsibility for supervising work to a licensed contsactor who is not. licensed to perform the vsork beiag done. Any p�rson working on your building who is not liceased must work under yovr direct supervision and must be P�ployed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with a11 applicable laws, ordivances, building codes, and zoniag re ations. owr�ft�s s=�� ' " �' � f� � � 1 �„ ADDRESS PHONE W2TNESS PERMIT #