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�ISCLOSURE S't'n'►'F*�•NT .FOR OWNER CZTY OF ZEPFiYRFiII�+S BL72I.D2NG DEPARTN�NT _� have read and fu11y understand and agree �to the provisions of �this instrument. The undersigned states and affirms that he or she is desirous of constructing, resionating, adding to or reroofing his or her own domicile, •that he or she actually occupies, or vri11 occupy by said domici:le, and same is not for •rent, lease or sale. That he or she sha11 comply with the followiing conditions: 1. Tha.t the owner and.he or she alone shall act as the builder for al1 phases of construction. 2. That the owner will comply with a1'1 provisions of �the City of Zephyrhills ordinances and codes pertineat to the building. 3. That in the ev�t various phases of construction are subcontracted, he will engage only �properly licsnsed subcontractors and will personally supervise such work. 4. Tha.t in the event the Huilding Inspector shall re�,;re corrections to be made, the owner wi11 assume full respoasibility �to insure •they are made, and upon completion wi11 cal3 for a re�T�+ectioa before proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the constsuction and ari11 not axpect_ supervision of his mork from the City of Zephyrhills Building Depart�exit. 6. That prior to final iaspection aay additional fees, including reinspection feas, must be paid in ful1. A writtan request from this office sha11 constitute axi official notice -to pay additioria7. fees. 7. That the owner sha11 comply mith a11 City, State and Federal laws ixi reg3rd to social security, workman's compensation, lien 1aws, etc. , where applicable. 8. That the owner sha11 comply with a11 the safety codes issued by the Florida 2ndustrial C�*+�ssioa. 9. 5tate 1aw rec�,;res constxziction to be done by licensed contractors. You have applied f'or a permit under au exemptioa to that law. The exemption allows you, as the owner of' your property, to act as your own contractor with cert=;T restrictions even though you do not have a license. You must provide direct onsite supervision of the constnlction yovrself. You may build or improve a oae-family or two-f'amily residence or a fasm outbuilding. You may also build or improve a commercial building, provided your costs do not e�cceed $25,000. Ttae building or residence must be for your own use or occupancy. St may not be L�ui1t or substantially i�proved for sale or lease. If you sell or lease a bvilding you have built or sut�stantially improved yourself within 1 year after the construction is complete, the laov �.11 presume �that you built or substasitially improved if for sale or laase, which is a violation of this exemption. You may not hire an ualicerised person to act as your contractor or to supervise people working ori yovr bvilding. It is your respoasibility to make sure that people employed by you have licenses rez,;red by state law and by county or muriicipal licensing ordiaances. You may not delegate the responsibility f'or supervisiag work to a licensed contsactor who is not licensed to perform the work being doae. Any person working oa your buildi.ng who is not liceased must work uncier your diract sttpervision and must be EIILployed by you, which meaas that you must deduct F.I.C_A. and withholdi.ng tax and provide workers' compensatioa for that employee, a11 as prescribed by law. Your construction must comply with a11 applical�le 1aws, ordinances, building codes, and zoning regu.lations. OWNER'S S 2GATAfiL7RE ✓� " / `� 1 ��`�" V� DATE � � / � � J � ADDRESS PHOIVE W2TNESS PEEtM2T #