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• DISCLOSIIRE S'�'IiTEI�'u'►' .FOR OW1�R CI.TY OF ZEPHYRHII�,S BIIII�DING DEPARTMENT _� ��'�` , �j' have read axid fu11y usiderstand aad agree ~to e provisions of •this ins �m�t. .The undersigned sta.tes and affirms that he or she is desirous of constructing, ranovating, adding to or reroofing his or her o�n domicile, •that he or she actually occupies, or wi11 occupy by said domicila, and same is not for •rent, lease or sa1e. That he or she shall comply with the followiiag condifiions: 1. That the owrler and he or she aloae shall act as the bui].der for al1 phases of construction. 2. That the o�aner w3:11 comply with all provisions of �the City of Zephyrhil'1s ordinances and codes pertinent to the building. 3. That in the evesit various phases of construction are subcontracted, he wi11 engage only �properly licensed subcontractors and wi.11 pe.rsonally supervise such work. 4. That in the event the Suilding Inspector sha11 rac�,;re corrections to be made, the owner vvill assvme full responsibility to insure •they are made, and upon completion will ca11 for a reinspection before proceeding Frith the building. 5. That the owner shall assvme �full responsibility for the construction and wi11 not axpect_ supervision of his work from the City .of Zephyrhills Building Dapas�ent. 6. That prior t� final inspectioa aay additional fees, including reinspection feas, must be paid ia ful1. A written request from this office shall constitute an official notice -to pay addi.tioxial fses. 7. That the owrier sha11 comply vrith a11 City, 5tate and Federal laws ixi reg3rd to social security, workmaa's compensatiaa, liea laars, etc. , where applicable. 8. That the owner sha11 comply with a11 the safety codes issued by the Florida Industrial Commissioa. 9. State law re?,;res construction to be done by licensed contractors. You have applied for a perm=t under an exemption to that law. �he exemption allows you, as the owner of your property, to act as your own cantractor with cert=;n restrictions ev� though you do not hane a lic�se. You must provide direct onsite supervision of the constniction yourself. You may build or improve a one-family or two-family resideace or a fasm outbuilding. You may also build or improve a commercial buildiag, provided your costs do not exceed $25,000. The building or residence must be for yovr own use or occupancy. It may not be bvilt or substantially i�proved for sale or lease. If you se1:l or lease a bvilding you have built or substantially iz¢proved yousself within 1 year after the cons�tsuction is complete, the law will pres�e that you .built or substantially a.mproved •if for sale or lease, which is a violation of this exemption. You may not hire an unlicensad person to act as your contractor or to supervise people working on yovr building. 2t is your responsibilit� to make sure that people employed by you ha.ve licenses rez,;red by state lavr and by county or municipal licensing ordiaances. You may not delegate the responsibility for supervisi.ng work to a licensed contractor who is not. licensed to perform the work beiag dnne. Ariy parson worksag on your bui.lding who is not licensed must work under your diract supervisioa and must be employed by you, whi.ch means that you must deduct F.=.C.A. and withholding tax and provide workers' compeasatiori fcr that employee, a11 as prescribed by law. Your constrLicti.on must comply with a11 applicable laws, ordinances, building codes, and zoning regulati � OWDIER'S S=Q� v� l�'�` / `" ADDRESS � ,- PHONE � �, � w=x�ss 'a�� `` �.J "u.-B'" ' " ,� : �xraT #