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DISCLOSi7RE S'►'A'�'*�•NT .FOR OWNER --C�-�'Y OF ZEPFiYRHSI�2�S BUILD2NG DEPARTMENT i�- // ^ � � �^� S, �d��--.-(� � `'� '�--•�---��- have read and fu1Zy understand and agree •to the provisions of �this instrument. The undersigned .states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, •that he or she actually occupies, or wi11 occupy by said domicile, and same is n�t for •rent, lease or sale. That he or she shall comply vrith the following conditioas: 1. That the owner asid_he or she alone sha11 act as the builder for al1 phases of canstruction. . 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the build:iag. 3. That in the enerst various phases of construction are subcontracted, he will engage only properly licensed subcontsactors and will personal�y supervise such work. 4. That in the enent the Building Inspector shall re�+,;re correcti.ons to be made, the owner will assume full responsibility to insure •they are made, and upon campletion wi11 ca11 for a rain r,ectioa before proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the construction aad wi1Z not axpect_ supervisioa of his work f'rom the City of Zephyrhills Building Depar�ent. 6. That prior to final inspection aay additional fees, including reinspection fees, must be paid ia fu11. A written request from ttiis office sha11 constitute an official notice to pay acldi.tional f'ees. 7. That the owner sha11 comply with a11 City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable, B. That the owner sha11 compZy with a11 the safety codes issued by the Florida 2ndustrial Com�i.ssioa. 9. State 1aw rern�ires cons�txuction to be done by liceased contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your prOpPSty, to act as your own contsactor with certain restsictions even though you do not have a license. You must provide direct onsite supervision o� the constructioa yovrsel£. You may build or improve a one-f'amily or two-family residence or a farm outbuilding. You may also build or improve a commercial bvilding, provided your costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a bvilding you have built or substasitially improved yourself within 1 year after the constructioa is complete, the laW Fri11 pres�e that you built or substaatially improved •if for sale or lease, which is a violation of this exempt�.on. You may not hire aa unlicensed person to act as your contsactor or to supervise people working on your building. It is your responsibility to make sure that people P�ployed by you have licenses re�,;red by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perForm the mork beixig dnae. Any persoa working on your building who is not licensed must work uncler your direct supexvision and must be P�ployed by you, which meaas tha.t you must deduct F.I.C.A. and withholcling tax and provide workers' compensation for that amployee, all as prescribed by law. Your construction must comply with a11 applicable laws, orclissances, building codes, and zoning regulations. - a _ --- OWNER'S S= L ��` DATE �ji " "[" "�� ADDRESS -" PHONE ��S 1 PERMIT #