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DISCLOSURE S'�'n'►'F'*�NT .FOR dWI�R CITY OF ZEPHYRHTZLS BVII�DIrTG DEPARTMENT S, ��D p . � have read and fu1Zy understand and agree •to tne rovisions of �this instzument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to os 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 shall comply with the following conditions: 1. That the owner aad_he or she alone sha11 act as the builder for all phases of constsuction. 2. That the owrier will comply with a11 provisions of the City of Zephyrhills ordinances and codes pertineat to the building. 3. That in the event various phases of construction are subcontracted, he will angage onZy •properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall re?';re corrections to be made, the owner will asstsme full responsibility to iasure •they are made, and upon completion will call for a reinspectioa before proceeding with the building. 5. That the ow�ner sha11 assume fu11 responsibility for the construction and wi11 not expect_ supervision o£ his work from the City .of Zephyrhills Building Depart�ent. 6. That prior to final inspection any additional fees, including reinspection fsas, must be paid ia ful1. A written request from this office sha11 constitute an official notice -to pay acidi.tioual fees. 7. That the owner sha11 comply with a11 City, State and Federal laws in regard to social security, workman's compe:asation, lien 1aws, etc. , where applicable. B. That the owner sha11 comply with a11 the safety codes issued by the Florida Industsial Coa�mission. 9. State 1aw rea+,;res coastructz.on to be done by licensed contractors. You have applied for a ��;t under an exemptioa to that law. The exemption allows you, as the owner cf your property, to act as your owa contractor with certain restrictions aven though you do not have a licesise. You must provide direct onsite supervision of the construction yovrself. You may build or improve a one-family or two-family residence or a farm outl�uildi.ng. You may also build or improve a commercial building, 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 substaatially s.mproved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within 1 year after the constructioa is complete, the la�v w�.11 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 ari ualicaasad person to act as your contractor or to supervise people �vorking on your buildirig. It is your responsibility to make sure that people employed by you have licenses rez,;red by state law and by county or municipal liceasing ordiaances. You may not delegate the responsibility for supervising mork to a licensed contractor who is aot. licensed to perform the work being doae. Asy parson working on your buildiag who is not licensed must work under your diract supervision and must be P�Ployed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, a11 as prescribed by law. Your construction must comply with all applicable laws, ord�siancas, building codes, and zoning regulations. r OWNER'S S2GtTATUgZE DATE jp'��f- 13 �axESS 5Zc 2 rD�.Der r' PHONE Q �^ .r,q - '7 W2TNES5 PEI2L�T #