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DISCLOSLJRE S'�'�R'F•*�•NT .EOR OWI�R CITY OF ZEPF3YRFiS�LS BIIII�DSNG DEPARTMENT _� ��7'�� + (�t�e,,((� have read and f'ully 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 domiczle, and same is not for •rent, lease or sal.e. That he or she shall comply with the following conditions: ,1. That the owner and.he or she alone sha11 act as the builder for al1 phases of const-suction. � 2. That the owner wi11 comply with a1l provisions of �the City of' Zephyrhills ordinances and codes pertinesit to the building. 3. That in the event various phases of construction are subcantracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspactor shall rez"re corrections to be made, the owner will assume full respoasibility to insure •they are made, and upon completion will ca13 for a rein_�ction before proceeding with tYie building. 5. That the owner sha11 assume full responsibility for the coastruction aad vri11 not axpect_ supervision of his work from the City of Zephyrhills Building Departmesit. 6. That prior to final inspection aay additi.onal fees, including reinspection fees, must be paid ia fu11. A written requast from tt�is office sha11 constitute an official notice to pay additional fees. _ 7. That the ownar sha11 comply vrith a11 City, State and Federal laws in regard to social security, worlcman's compensation, lien laws, etc. , where appli�able. B. Tlzat the owner sha11 comply with a11 the safety codes issued by the Florida Industrial C��ssion. 9. State law ree+,;res constr�iction to be done by licensed contractors. You have applied for a permit uader an exempts.on to that law. The exemption allows you, as the owner of yovr property, to act as your own contractor with certain restsictions even though you do not ha.ve a license. You must provide direct onsite supervision o�' the construction yovrself. You may build or improve a one-family or two-family residesice or a farm outbuilding. You may also build or improne a commercial building, provided your costs do not eaceed $25,000. The building or residence must be for yovr own use or oceupancy. =t may not be built or substaati.ally improved for sale or lease. 2f you se1.l or lease a bvilding you have built or substantially improved yourself withia 1 y@as after the const-suction is complete, the law wi.].1. presume •that you built or substantially improved •if for sale or lease, which is a violation of this EXP�Ptioa. You may not hire aa vnlicensad pErson to act as yovr contsactor or to supervise people working on your bvildiag. It is your responsibili:ty to make sure that people e�ployed by you ha.ve licenses re?,;red by state law and by county or municipal licensing ordinances. You may not delegate the responsa.bility for supervisiag work to a licensed contractor who is not. 1ic�nsad to perform the mork being dnae. Arsy pgrson worki.ag on your building who is not licensed must work under your di.rect supervisioa and must be P�ployed by you, which meaas that you must dsduct F.I.C.A. and withholding tax and provide workers' compesisatioa for that P�ployee, all as prescribed by law. Your const-suction must comply with a11 applicable lavrs, ord.iaances, building codes, and zoning regulations. �R,S�� L� n� :i ro-a � � �� ADDRE S S /� "�?� Q r L PHONE - � - S' W2TNE5S PEFtMIT #