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DISCLOSiJRE S'►'a'T'�•*�•NT .FOR OW1�R CI.TY OF ZEPHYRIiSI+LS BiT=LD2NG DEPARTMENT 2� ✓ •��e`�y ��-�}w Lfr,/ have read and fully understand and agree �to -the provisions of �this instrument. The undersigned states arid affirms that he or she is desirous of constructing, r�ovating, adding to or reroofing his or her own domicile, •that he or she actually occupies, or wi11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she sha11 comply with the fol7.owing condi.tioas: 1. That the cwsier aad he or she alone sha11 act as the builder for al1 phases of constri.icti on. � 2. T2zat the owner wi11 comply with a11 provisions of �the City of Zephyrhills ordinances and codes perti.neat to the buildiag. 3. That in the event various phases of' construction are subcontracted, he will engage only properly licensed subcontsactors and will personally supervise such work. 4. That i.n the event the Building Inspector shall ree�';re corrections to be made, the owner will assume full responsibility to insure �they are made, and upon completion will ca11 for a rein�cti.on before proceeding with ttie buildiag. 5. That the owner sha11 assume fu11 rasponsibility for the const-suction aad wi11 not axpect_ supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection aay additsonal fees, including reinspection fees, must be paid ia full. A vrritten request from this o£fice sha11 constitute an official notice -to pay additional fees• . 7. That the owner sha11 com�ly with a11 City, State and Federal laws in regard to soci.al security, worlcman's compansatian, Lien laws, etc. , where applicable. 8. That the owner shall comply with a11 the safety codes issued by the Florida Industrial C��ssion. 9. State 1aw rarn�ires constxziction to be done by licensed contractors. You have applied for a permit under an exe�ption to tt�t law. The exemption allows you, as the ooazaer of yovr propESty, to act as your owa contractor with certain restrictions even though you do not hane a license. You must provide direct onsite supervision o�' the constxl3ction yovrself. You may build or improve a one-family or two-family residence or a fatm outbuildiag. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The building or resideace must be for yovr ovrn use or occupancy. 2t may not be built or substaatially improved for sale or lease. If you sell or lease a building you have built or substaatially improved yourself within 1 year after the constsuctioa is complete, the law will pres�e that you built or substantially improved •if for sale or lease, which is a violation of this ex�ption. You may not hire an unlicensed person to act as yovr contractor or to supervise people working on your building. It is yovr responsibility to make sure that people employed by you lza.ve licenses rez,;red by state law and by county or municipal liceasa.ng ordiaances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the ovork beiag doaa. Any person working on your building who is not licensed must work under Zsour dirsct sispervision and must be P�ployed by you, which meaas that you must deduct F.I.C.A. and withholding taz and provide workers' compensation for that employee, all as prescribed by law. Your constrtiction must comply with a11 applicaUle laws, ordisiances, building codes, and zoning ragu.lations. o�R- S S=�� D� �-_ a s- �3 ADDRE S 5 / d�/.2�L � PHONE -7 2_ g�3 � t - 7! -f� S�l W=TNESS PERMIT #