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. DISCLOSURE S'�'�-'r'�*�•NT .FOR OW1�R CITY �E ZEPFiYRFi2L7,S BVILDING DEPARTMENT _ � y have read and fu11y understaad aad , �� L �',-.�� - agree �to the provisions of 'th.ZS instrumesit- The undersigned states and affirms that he or she is desirous of constructing, resionating, adding to or reroofing his or her ovrn domicilg, 'that he or she actually occupies, or wi11 occupy by said domica:le, and same is not for •rexit, lease or sale- That he or she shall comply with 'the following conditions: 1 That -the a�ner and_he or she alone sha11 act as the buil.der for a11 phasss of constsucti.on. 2. That the owsser wi11 comply with a11 provisions o£ �the City of Zephyrhills ordirlances and aodes pertineat to the l�uildiag. 3. That in the event various phases of construction ase subcontracted, he will er�gage only •properly licaased subcontractors and will personally supervise such work. q, Z'hat in the event the Bvilding Inspeator sha11 rec�,;*'e correcti.ons to be made, the owner wi11 assume full responsit�ilitY to iasure •they ase made, and upon co�pletion will ca13 for a rea.aspeatioa be£ore proceeding �-th the building. b. That the owner shall assume fv11 rasponsibility for the const-suctioa aad vPi11 aot axpect_ supervisioa of his work fro� the City of Zephyrhills Building Dapastmeslt. 6. 2*21at prior to final inspection any add3-ti-as�7- fe�s, ��uding reinspection fsas, must be paid i.a full. A written requast from this office sha11 constitute an official notice 'to pay addi.tiosial fe6s.. _ 7. That the o�aner sha11 co�ply with a11 City, State and Fedesal laws in regaSd to social security, warkman's compeasatioa, lieri laws, etc. , where applicable. B. That the owner slzall comply with a11 the safety codes issued by the Florida Industrial Comm.ission. 9. State 1aw rez,;res constsuction to be done by licensed contractors. You have applied for a permit under ati exemption to that lam. The exemption allows you, as the owner of your property, to act as your own contractor with cert=; restsictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself• You may bvild or improve a one-family or tvPO-family reside�,ce or a farm outbuilding. You may also build or improve a commercial buildixi4� Pre°�-ded yovr costs do not exceed $25,000. The building or residence must be for yovs own use or occupancy. St may not be built or substantially improved for sale or lease. If you se]:1 or lease a building you have built or substantially imProved yourself within 1 y�ar after the const-suction is complate, the law wi.11 pres�e •that you built or subst�riti.ally improved •if for sale or lease, which is a violation of this exemption. You may not hire an ualicexis�d person to act as yovr contractor or to supervise people working on your builds.ng• It is your responsibility to make sure that people employed by you have liceases rez,;red by state law and by covnty or muriicipal licensing ordinances. You may not delegate the responsibility for supervisiag work to a licensed contractor who is not licensed to perform the mork beiag doaa. Axiy parson working on your building who is aot licensed must work uncle= your disect supervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' compeasation for that employee, a11 as prescribed by law. Your coastruction must comply with a11 applicable laws, ordinances, building codes, and zoning regula �oas. owr�R�s sz�z�a�x� �/�� n� ' -�1,�— �DxESS 1/ PHONE .. W=TNESS � .. p-7�C�e� �! - PERMIT #