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� DISCLOSURE S'�'A'►'F•*�NT .FOR OW2�R CZTY OF .ZEPHYRI3=I+ZS SLTII+DING DEPI�1lL'�'►�•NT _ � have read and fully understand and � - - agree •to the provisions of �this instrument. The undersigned states and affirms ttsat he or she is desirous o£ constructing, renovating, adding to or reroofing his or her own domicile, �that he or she actually occupies, or will occupy by said domici:le, and same is not for •rent, lease or sale. That he or she shall comply v,rith the followiing condi-tions: 1. That the owuer and.he or she alone shall act as the build�r for a11 phases of construction. 2. That the owner will comply with a11 provisions of the City of Zephyrhills ordinances and codes pertinent to the build:'tng. 3. That in the event various phases of coastruction are subcontracted, he will en�age only properly licensed subcontractors and will personally supervise such work. q. That in the avent the Building =nspector shall re?,;re correcta.ons to be made, the owner wi11 assume full responsa.bility �to insure •they are made, and upon completion wi11 ca13 for a reinspection before proceecling with the building. 5. That the owner sha11 assume fu11 respor�.sibili�ty for the constsuction aad oPi11 not eapect_ supervisioa of his work from the City .of Zephyrhills Building Depas�ent. 6. That prior to final inspection aay additional fees, including reinspection feas, must be paid ia ful1. A written raquest from this office shall constz.tute an official notice rto pay addi..tional fees. 7_ That the owner sha11 comply with a11 City, State and Federal laws in regaLd to social security, workman's comperisation, lien laws, etc. , where applicable. B. That the ownws sha11 comply with all the safety codes issued by the Florida Industrial Commission. 9. State 1aw re�,;ras consttuction to be done by licensed contractors. You have applied for a permit under axi exemption to that law. The exemption allows you, as the owner of your property� to act as yovr own contractor with ep*-+�a�*+ restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yovrself. You may build or improve a orie-family or two-family residsnce or a farm outbuilding. You may also build or improve a commerca.al bvilding, provided your costs do not exceed $25,000. , The building or residence must be for your own use or occupancy. St may not be built or substantially improved for sale or lease. If you sel:l or lease a buildiag you have built or substantially i�proved yourself v�rithin 1 year after the construction is complete, the law will pras�e •that you .built or substantially a.mproved if for sale or laase, which is a violati.on of this exe�ption. You may aot hire an unlicensad p@rson to act as your contractor or to supervise people working on your building. It is your responsibility to make sure that people emplayed by you have licenses rei,;red by state law and by county or mun.icipal liceasing ordivaaces. You may not delegate the responsi.bility for supervisi.ng work to a licensed contractor who is not. licensed to perform the work being doa@. Ariy person worki.ng on your building who is aot licensed must work under yovs direct supexvision and must be employed by yau, which meaus that you must deduct F.I.C.A. and withholcling tax and provide workers' compEIIsation for that employae, al1 as prescribed by law. Your construction must comply with a11 applicable laws, ordinances, building codes, and zoning regulatioas. OWNER'S SIGNATURE ' DATE ,,3 G Z �y ADDRESS � - PHONE ( W2TNESS �'-Q�T #