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• DISCLOS S't'n'►'F'�•NT .FOR OW1dER �'\ CITY OF ZEP SI�I+S BIIITrDSNG DEPARTMENT = r C�� _�if/, have read and fu11y understand arid agrae •to the provisions o ins ent. The undersigned states and affirms that he or she is desirous of const=ucting, renovating, adding to or reroofing his or her own domicile, •that he or she actually occupies, or wi11 occupy by said domiczle, and same is not for •rent, lease or sale. That he or she shall comply with the fo3.lowing conditions: 1. That the os•mer and-he or she alone sha11 act as the builder for a11 phases of construction. - 2. That the owner will comply with a1l provisions of the City of' Zephyrhil'ls ordinances and codes pErti.nent to the building. 3. That in the enent vasicus phases of construction ase subcontracted, he will engage only properly liceased subcontractors and will personally supervise such work. 4. Z`hat in the event the Suilding Znspector sha11 re?,;re corrections to be made, �he owner wi11 assume full responsibility to insure •they are made, and upon co�pletion will ca11 for a rpi*+-�ctioa before proceeding with the building. 5. That the ownar sha11 assume fu11 responsibility for the constr�action and wi11 not expect_ supervisiosi of his work from the City of' Zephyrhills Buildi.ng Department. 6. That prior to final inspection any addi.tional fees, including reinspection fees, must be paid ia fu11. A writtan request from t_h.is office shall constitute an official notice -to pay additioria.l f'ees. 7. That the owner shall co�ply with a11 City, State and Federal laws in regard to social security, workmari's compensatioa, lien laws, etc. , where applicable. 8. That the owner sha11 comply vrith all the safety codes issued by the Elorida Industrial Commission. 9. 5tate 1aw rem,;Tes constxziction to be done by licensed contractors. You have applied for a pexmit undes an exemption to that law. The exemption allows you, as the owner o£ your property, to act as your own contractor vrith ce*�+=;*+ restsictions even though you do not have a license. You must provide direct onsite supervision of the construction yovrself. You may build or improve a one-family or two-fami.ly residence or a farm outbuildiag. You may also build or improve a commerci.al bvilding, provided your costs do not exceed $25,000, The building or residence must be for yovr own use or occupancy. It may not be built or substaatially improved for sale or lease. 2f you se1:l or lease a building you bave built or substaatially improved yoursplf within 1 year after the constsuction is complete, the la�v wi11 presume that you .built or substantf.alZy improved •if for sale or lease, which is a violation of this exP�FJtioa. You may not hire an unlicexisad person to act as yovr contractor or to supervise people working on your building. 2t is your responsibility to make sure that people e�ployed by you have licenses rez,;red by state law and by county or murii.cipal liceasing orclinaaces. You may not delegate the responsibility for supervisi.ng work to a licensed contractor who is not licensed to perform the �oork being dnae. Ariy person working on your building who is not licensed must work uncler Irour direct supervision and must be Employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide worlcers' compensation for that employee, all as prescribed by law. Your construction must comply with a11 applicahle laws, rdiiaances, building codes, and zoning regu.latio OWNER'S S 2 GNATL7RE �� `�" ADDRESS PHONE � � W2TNESS PERMIT # /