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DISCLO&IIR8 STAT�AT FOR OWNBR CITY OF ZSPBYRHILLB HIIILDING DBFART�TP I, T�IC �/�SQn have read aad fully naderstaad aad agree to the provi.sions of this iastrumeat. - The undersigaed states aad affirms that he or she is deairous of canstxuctiag, ren.ovatiag, addiag to or reroofing his or her oNa dom�.cile, that he or ahe actually occupies, or vrill oceupy by said domicile, and same is aot for rent, lease or sale_ That he or ahe sha11 co�aply avith the folloari.ag conditions: I. That the oovner aad he or she alone shall act as the bni.lder for all phasea of construction._ 2_ That the oaraer vri11 com�ly �vi.th all provisioas of the Ci�ty of Zephyrhills ordiaaaces aad codes pertiaeat to the bui.ldin.g. 3. That ia the eveat variovts phases of constructioa ase subcoatracted, he mi.11 EEIIgage oaly properly liceased subcoatractors aad mill persoaally supes4ise such work_- 4. That in the eveat the Building Iaspector shall require corrections to be made, the owaer will assume full respoasibiZity to insnre they. are made, and upoa completioa w:ill ca11 fcr a reinspecti.on before proceediag with the building. 5. That the ownes shall assume full respoasibility for the construction and w:i.11 not expect supervision of his work fraa� the City of �ephyrhills Bnildiag Departmeat. 6_ That prior to final iaspeatioa any additioa.al fees, inclnding reinspection feea, must be paid ia full. A rorrittea, reqnest from this cffice shall aonstitute aa official aotice to pay additioaal £ees. 7. That the oe�aer shall comply with all City, State aad Federal laws in regard to social security, workmaa's compeasation, Iiea lav�s, eto., �hese applicable. 8. That the oaPner shall c�ly av3.th all the safety cades issued by the Florida IadustriaZ Co�i.saioa. 9. 3tate Zaw requires coastruction to be done by liaensed contractars. You ha.ve applied far a permit uader aa exe�ptioa to that law. The e�cemptioa allows yau, as the owaer of yonr property, to act as your owa coatsactor mi.th certain restrictions evea though you do not have a licease. You must provide direct oasite supexvision of the constraction yourself. You may build or improve a one-fami.Iy or tmo-fami.ly resideace or a farm outbuil.diag_ You may also build or improve a com�aercial buildiag, provided yonr costs do not exceed $25,OQ0. The buildiag or resideace must be for your owa use or occupaaey. Tt may not be built or substantially improved for sale or lease. Zf you sell or lease a .bu:i.ldiag you have built or substaatially impsoved yourself withia J. year after the constructioa is complete, �he Zaw ovill presume that you built as substantially improved if for sale or lease, which is a violatioa of this exemption_ Yon may aot hire aa unliceased persoa ta act as yovr coatractor or to supervise people morking on yaur buiid:i.ng. It is your responsibility to saake snre that people employed by you have licenses rem��red by atate lav� and by cpuaty or mua%cipal liceasiag ord3nances. You may not delegate the =espeasibility for supervisiag wark to a liaensed contractor aiho is aot licensed to pexform the v�ork being done. Aay persoa workiag oa you� bui3ding who is aot licensed must �vork uader yovr direct superv3,sioa aad must be employed i�y you, whi.ch meaas that you must dedttct F.I.C.A. aad withholdi.ag tax aad provide rovorkers• campeasatioa far that �aployee, all as prescribed by Iasv_ Your constxuctioa must comply �rith aI applicable Iaavs, or��an�es, bnildi.ag codes, aad zoaing regalati.ons� aW11ER'S SIQ3�►TIIR I `Z`-i - ZO(� DBTS ADDRBSS (�¢/'f L /'. ZQ . PHONS eZ -S��(�-' Vi1IT1�i8SS � ` PERMIT #