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' DISCLOSVEtE STa'�'*�•u'r' .FOR OWt�R CITY OF ZEPFiY32H2LZS BVII�DIldG DEPARTMENT � _, _ have read and fully understand and agree -to provisions of � 's instrument. The undersigned states aad affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her orovzi domicile, �that he or she actually occupies, or wi.11 occupy by sai.d domicile, and same is not for �rent, lease or sale. That he or she shall comply with the following conditions: 1. That the owzier and_he or she alone sha11 act as the builder for al1 phases of cons tsuction. 2. That the owner will comply with a11 provisions of the City of Zephyrhills ordinances and codes pertinent to the .buildiag. 3. That in the enent various phases of construction are subcontracted, he wi11 engage only •properly licensed subcontsactors and will personal�.y supervise such work. 4. 2'hat i.n the event the Huilding Inspector shall rarn„re corrections to be made, the owner wi11 assume full responsibility to insure •they are made, and upon completi.on will ca11 far a rei*+-�ctioa before proceeding with the building. 5. That the owner sha11 assume fu11 responsibility for the constrtaction and vTi11 not expect_ supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional £ees, including reinspection feas, must be paid ia fu11. A wsitten request from this office shall constitute an official notice -to pay additioaal fees. 7. That the owner sha11 comply with al1 Ci.ty, State and Eederal laws in regard to social security, warkma,n's compeasation, lien laws, etc. , where applicable. B. That the owner sha11 comply �rith all the safety codes issued by the Florida Industrial Commission. 9. State 1aw rec�,;res construction to be done by licensed contractors. You have applied for a permit under an exe�ption to that law. The exemption allows you, as the owner of yovr property, to act as your own contractor with certaia restrictions even though you do not hane a license. You must provide direct onsite supervision of the constniction yovrself. You may build or improve a one-family or two-family resideuce or a farm outbuilding. You may also build or a�prove a commercial �++,;ia;Tg, provided yovr costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may aot be bui.lt or substantially �.mproved for sale or lease. If you se1:1 or lease a building you have built or substantially improved yousself v�rithin 1 year a.fter the constrtictioa is complete, the laa wi.11 prest�e •that you built or substanti.ally improved �if for sale or laase, which is a violation of thi.s ex�ption. You may not hire an un7_icensed person to act as your contractor or to supervise people working on yovr building. rt is your respoasibility to make sure that people employed by you have licenses rei,;red by state law and by county or muaicipal liceasa.ng ordinances. You may not delegate the responsibility f'or supervising work to a licensed contractor who is not. licensed to perform the work beissg dnne. Any parson working on your building who is not licensed must work urider your diract supervision and must be employed by you, which meaas that you must deduct F.I.C.A. and withholding tax and provide workers' compeasation for that employee, al1 as prescribed by law. Yous constrtiction must comply with a11 applicable lavrs, ordiaances, building codes, arid zoning regulatioas. �R-S Sz�� o�' �� Dp�'E �!�—/�_// ADDRESS $ PHONE � _ W2TNES5 PEFtMIT •t� ..•-