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DISCLOSURE S'�'n'►'F'*�'•NT .FOR OWt�R CZTY OF ZEPHYRFi2L7.S SVII�DING DEPARTlV�NT I, _ . U�� have read and fully vnderstand and agree to the provisions of �this strument. The undersigned states and irms that he or she is desirous o£ constructing, renovating, adding to or raroofing his or her own domicile, •that he or she actually occupies, or wi11 occupy by �'/-- �g -/� said domiczle, and same is not for •rent, lease or sal.e. That he or she shall comply with the followiing condi-tions: 1. That the o�mer and_he or she alone sha11 act as the bvilder for a11 phases of constsuctian. 2. Ttiat the owner will comply with al:l provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the enent various phases of construction are subcontracted, he wi11 engage only •properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector sha11 re?+��re corrections to be made, the owner tQill assume full responsibility to insure •they are made, and upon coiapletion will ca11 for a r��*�-�ctioa be£ore proceeding with the building. 5. That the owner sha11 assume fu11 responsi.bility for the construction and vTi11 not expect_ supervision of his work from the City of Zephyrhills Building Depar�tent. 6. That prior to final inspection aay additional f'ees, including reinspectioa fees, must be paid ia ful1. A vPrittan raquest from this office sha11 constitute an official notice -t� pay additional fees. 7. That the owner sha11 comply with a11 Ci.ty, 5tate and Federal laws in regard to social security, workman's compaasation, liea 1aws, etc. , where applicable. B. That the owner sha11 comply with al1 the safety codes issued by the Florida Industrial Comm.i.ssion. 9. State 1aw rea+,;ras construction to be done by liceased contractors. You have applied for a peT+�+�t under ari �cemptioa to that law. The exemption allows you, as the owner of your prop22'ty, to act as your own contsactor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the constsuction yourself. You may bvild or improve a one-family or two-family residaace or a farm outbuilding. You may also build or improve a commercial �++,;i�;rq, provided your costs do not exceed $25,000. Z'he building or residaace must be for yovr own use or occupaacy. It may not be built or substantially improved for sale or lease. If you sel:l or lease a bwilding you have built or substantially improved yourself within 1 year after the construction is complete, the law wi11 pres�e •that you .built or substantialZy i.mproved •if for sale or laase, which is a violation of this ex�ption. You may not hire an unlicensed person to act as your contsactor or to supervise people working on your buildiag. It is your responsiUility to make sure that people P�ployed by you ha.ve licenses rez+,;red by state law and by county or muui.cipal licensing ordiaances. You may not delegate the responsibility for supervising work to a licensed contractor vrho is not. licensed to perform the work beixig doae. Axiy parsoa 9oorking on your building who is not licensed must work under your direct supexvision and must be employed 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 constructi.on must comply with a11 applicable laws, ordinances, building codes, and zoning regulatio s. � owxER�s s=�� ,�_�- a� /D -a`� - aDi � ADDRESS � _y-� PHONE W=TNE S ' � �_- ' C- � PEF2MIT #