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• DISCLOSURE S't'n'►'F*�•NT .FOR OWI�R CITY OF ZEPHYRFiII+ZS BIIII�D2NG DEPARTMENT _� �� %�/��s(, have read and fully understand aad agree •to the provisions of �t�iis instrument. The undersigned states and affirms that he or she is desirous o£ 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 •r�t, lease or sale. That he or she shall comply with the following conditions: 1. That the owner and.he or she alone sha11 act as the builder £or a11 phases of constsuction. 2. That the owner will comply with al1 provisions of •the City of Zephyrhil'ls ordinaaces and codes pertinent to the building. 3. That in the everst various phases of construction are subcontsacted, he will engage only properly licensed subcantractors and will personally supervise such work. 4. That in the event tlze Huilding Inspector shall rec�,;re correcti.ons to be made, the owner wi11 assume full responsibiLity to insure •they are made, and upon completion will ca11 for a rein�ection before proceeding with the build.ing. 5. That the owner sha11 assume fu11 responsibility for the constsuction and vTi11 not axpect_ supervisian of his work from the City o£ Zephyrhills Building Depar'I�ertt. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid ia full. A written request from this office sha11 constitute an official notice to pay addi.tioxial fees. . 7. Tha.t the ownes sizall comply vrith a11 City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. B. That the ownes sha11 comply with al1 the safaty codes issued by the Florida Industrial Comm.ission. 9. State 1aw re�,;res constzliction to be done by licensed contractors. You have applied for a pp��t under axi exemptioa to that law. The exemption allows you, as the owner of your property, to act as your own contractor vrith certain restrictions evea though you do not have a license. You must provide clirect onsite supervision of the coastnzetion yourself. You may build or improve a one-family or two-family residence or a fasm outbuilcling. You may also build or improve a commercial building, provided your costs do not exceed $25,000. �he building or residence must be for yovr own use or occupancy. It may not i�e built or substantially a.mproved for sale or lease. If you se1:l or lease a buildiag you have built or substantially improved yourself within 1 year after the construction is complete, the laov wi11 presume that you .built or substantially improved •if f'or sale or laase, which is a violation of this exemption. You may not hire an unlicenssd person to act as your contractor or to supesvise people working on yovr buildiag. It is yovr responsibility to make sure t�at people e�ployed by you have licenses rez,;red by state law and by county or municipal liceasing ordiaances. You may not delegate the responsibility for supervising work to a licensed coatsactor who is not. licensed to perform the work being dona. Any person working on your building who is not licensed must work urlder Zrour diract supervision and must be P�Ployed by you, which meaas that you must deduct F.2.C.A. and withholding t== and provide workers' compEIlsation for that P�ployee, all as prescribed by lam. Your construction must comply with al1 applicable 1aws, ordinances, building codes, and zoning regulations. f OWNER'S SIGbiAfiLTRE� DATE �� ADDRESS � �' r�L PHOIJE - c� _ W=TNESS PEFtMIT #