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' �ISCLOSURE S'�'a'T'F•*�+�"NT .FOR OW1�R CITY OF ZEPHYRFiISZS BUII�DING DEPARTi�NT 2, 1/��CQ� �'/U/� _ �q�e� _ have read and fully understand aad agree •to the provisions of •this instrument. The undersigned .states and affirms that he or she is desirous of' constructing, ranovating, adding to or xeroofing his or her ov�rn domicile, •that he or she actually occupies, or wi.11 occupy by said domic3:le, and same is not for •rent, lease or sale. That he or she shall comply with the followiing conditions: 1. That the owsaer and_he or she alone sha11 act as -�he build�r for a11 vhasss of constructi.on. . 2. That the owner wi11 comply with a11 provisions o£ •the City of Zephyrhills ordinaxices aad codes pertineat to tl�e .bui.lding. 3. That i� the enent various phases of' construction are subcontracted, he will engage only �praperly licensed subcontractors and will person�.l�y supervise such work. 4. That in the event the Huilding Inspector shall rsc��ire corrections to be made, the owner wi1Z assume full respoasibility to insure •they are made, and upon co�pletion will ca13 for a reiaspection before proceecling with the building. 5. That the owner sha11 assume fu11 respansibility for the constsi.iction and wi11 not axpect_ supervision of his work from the City of Zephyrhills Building Depast��t. 6. That prior to final inspection any ac3ditional fees, including reiaspection fses, must be paid ia �full. A written raquast £rom this office sha1.1 aonstitute an official notice �to pay additioaal fees. 7. That the ovPner shall comply with a11 City, State and Federal laws ia regard to social security, workman's c�+�Q*+�ation, lien laws, etc. , where applicable. B. That the ownes sha11 co�ply with all the safety codes issued by the Florida Industrial C��ssioa. 9. State 1aw rec�,;res construction to be done by licensed contractors. You have applied for a �*�+;t under an exemption to that la�v. The exemption allows you, as the owner of your property, tc act as your own contractor Frith certain restrictions even though you do not hane a lic�se. You must provide direct onsite supervision of the coastruction yourself. You may build or improve a one-family or two-family resideace or a farm outbuilding. You may also build or improve a commercial building, provided yovr costs do not exceed $25,000. The building or resideace must be for yovr own use or occupancy. It ma.y not be built or substantially improved for sale or lease. If you se1:l or lease a building you have built or substantial.ly improved yourself within 1 yeaz after the construction is complete, the law wi11 presume �that you built or substanti.ally improved •if for sale or laase, which is a violation of this exempti.on. You may not hire an u�ticensed person to act as your contractor or to supervise people working on your buildiag. 2t is your responsibility to make sure that people employed by you have licenses re?,;red by state law and by county or municipal licensing ordiaances. You may not delegate the responsibility for supervising work to a liceased contractor who is not. licensed ta pexform the oaork being dona. Any persoa working on your building who is not licensed must work unciar yovs diract supervisioa and must be employed by you, which meaas that you must deduct E.I.C.A. and withholcling tax and provide workers' compeasation for that employee, a11 as prescribed by law. Your construction must comply with al1 applicable laws, ordinances, builcling codes, and zoning regulations. OWNER`S S2Q�TI7RE i�� DATE � I S f l(J) � � ADDRESS � -= �" Tr , PHONE '1 ��--(�I t f' t-t� � 3 S`-( L-�' W2TNES5 PERM2T #