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DISCLOSURE BTATF�t+�rNT FOR O�PNER CITY OF ZEPfI7CR�IILI.S BUII.DING DEPAR'1't�NT I. �l��jj�. �J . ��7`�iY�- have road and fvlly undoratand aad agr�e �to tha provisioas of this inatr�nt. ThQ uridarsignod atatas aad affirms that he or ahe is d�sirous of constructing, ran�v:ting, :dding to or raroofiag his or har o�an d�.icilo, that h� or shQ actually occupias, ar pill occupy by said do�.ailo, and �amQ is not for rQnt, leas• or sale. That ha or sho ahall comply pith the £ollo�ing conditiona: 1. That the ownar and ha or she alone shall act aa the build�r for all phasos of con8truction. 2. That tho oanar Nill co�ply xith all provisioas of the City of Zophyrhills ordinaacas aad aodps portinoat to tho .building. 3. That in tha evont various phasos of construction aro subaoatractod, ha will �gage only proparly liannsod subcoatractors and rrill parsonally suparvise such �rork. 4. That in tho evoat tho Building Inspoctor shall roi�ire corractiona to be mada, the owaar will assuma full roapoaaibility to insuro thoy az� mad�, and upon complatioa ►rill call for a roa.nspQetioa boforo proc�ding with tho buildinq. 5. That tho o�anar sha11 assumo full rospon�ibility for ttw construction and Kill not axpect suporvision of his vrork from tho City of Zrphyrhills Building Dwp�rtmont. 6. That prior to firia]. inapoction s�► additional fa�s, includisig rwiasp�etion £ows, must bo paid in full. A xrittaa roquast fron this office ahall constituto an official notice to pay additional f�a. 7. That th� ovmar shall comply Kith all City, StatQ and F�ral laxs in raqard to social socurity, �rorkman's comp•nsstion, lioa laas, Qtc. , �►laQro appliaable. 8. That tho oxnar shall ao�ply xith all th� safQty cod�s isauad by the Florida Industrial Ca�mission. 9. Stato lap requisss coastruction to bo dono by lic�aod contractors. You have appliod for a poxmit usider an �ca�ption to that la�v. Tha �comption allops you, ia tha o�or of your proparty, to act as your owa contractor pith aortain restrictions av�n though you do aot havo s lioenso. You must provide diract onsite euporvision of thQ conatructioa yoursalf. You aay build or improvo a one-fami.ly or tpo-family rasidenw or a farm outbuilding. You may al8o build or i.mprove a co�rcial building, provicLd your costs do not oza�d $25,U00. Tha buildiag or rQsid�ac� must bQ for your own uso or occupancy. It may not bo built or substantislly improvad for sale or loase. If you aall or loaao a building you havo built or substantially iaprovod yours�lf �aithia 1 y�ar aft�r the aonstruction ia compl�to, the la�v �vill prasuno that you built or aubstsntially improvod if for salo or loaso, Mhich ia a violation of this oxamption. You may not hire an uri].iaonsod poraon to act as your contractor or to supornisw pooplo o�orkinq on your building. It is your roaponsibility to mako sura that poop2� a�ployQd by you hava lioaasws raquirod by state la�+ aad by aounty or municipal licansing ordinancc�s. You may aot doloQat�a tha raspoasi.bility for suporvisiag work to s licoasod contractor who is not liaons�d to por£orm tho work boi.ng dono. Ariy paraon working on your buildiag who ia not licwasad aust �vork undor your dir�ct suporvieion arid must bQ employod by you, which maans that you must dpduct F.I.C.A. aad orithholdiag tax and provide �vorkars' cosponsatioa for that a�ploy�, all as pr�scaribod by lsw. Your construction must aomply with all applicsble laws, ordinancos, building codps, aad zoning ��agu�ation�� O�R'S SIGNATCTItE ✓ � /D-22-�q ADDRESS PH0�7� WITNE33 P�32bIIT �