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� DISCLOSURE SmA'►'F�•NT F�R OW1�R CZTY OF ZEPHYRH2.T�I+S SIII?rDING DEPARTMENT � _ � have read and fully understand and , - agr •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 domi.cile, •that he or she actually occupies, or wi11 occupy by said domici:le, and same is not for •rent, lease or sale. That he or she shall comply �rith the following conditions: 1. That the owsier and.he or she alone sha11 act as the builder for a11 phases of construction. � 2. That the owner will comply with a11 provisions of �the City of Zephyrhills ordinances and dodes p6x'tlllent to the buildiag. 3. Tha-t in the event varicus phases of construction are subcontracted, he will engage only properly licensed subcontractors and will pPSSOnally supervise such work. 4. That i.n the event the Suilding Inspactor shall rec�"re corrections to be made, the owncs will assume full responsibility to insure •they are made, and upon completion will ca13 for a reinspection before proceecling with the bisildiag. 5. That the owner sha11 assume fu11 respons3.bility for the construction and wi11 not axpect_ supervision of his work from the City .of Zephyrhills Building Depas�ent. 6. That prior to final inspection any additional fees, including reinspection faes, must be paid ia ful1. A written raquest from this office sha11 constitute an official notice -to pay additional fees. _ 7. That the owner sha11 comply with a11 City, State and Eederal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. B. That tlze owner sha11 co�ply vrith a11 the safety codes issued by the Floricia Industrial C�+++�ssion. 9. State 1aw reQ+,;*-es constrLiction to be done by licensed contractors. Ycu have applied for a permit under an exempts.on to that law. The exemption allows you, as the owner o£ your propPSty, to act as your own contsactor with certain restrictions even though you do not ha.ve a license. You must provide direct onsite supervision o� t1�e constraction yourself. You may build or i.mprove a one-family or two-family residesce or a farm outbuilcling. You may also build or improve a commercial buildiag, provided yovr costs do not exceed $25,000. The building or residence must be for your own use or oceupancy. It may not be built or substariti.ally improved for sale or lease. If you sell or lease a bvilding you have built or substantially improved yourself within 1 year after the constsuction is complete, t�he law will presume that you built or substantially imp=oved •if for sale or lease, which is a violation of this exemptioa. You may not hire an unlicessad person to act as yovr contsactor or to supervise people working on your builds.ng. It is yovr responsit�ility to make sure that people employed by you have lic�ses re?,;red by state law and by county or muriicipal liceasing ordinances. You may not delegate the responsibility for supexvising work to a licensed contractor who is not licensed to perform the mork being dnaa. Any parson working on your building who is not liceased must work under your di.ract supervision and must be employed by you, which meaas that you must deduct E.I.C.A. and withholding tax and provide workers' comperisation for that employee, all as prescribed by law. Your construction must comply with a11 applicable 1aws, ordissances, building codes, and zoning regulatioas. OWNER'S SIGNA '-� . • nn'�' / �/ /� ADDRESS f �' PHONE W2TNE S PERI�T #