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� , DISCLOSURE S NT .FOR l7'W2�R d' CITY OF ZEPIiYJ?F3SI�I.S " I�DING DEPARTMERII' =j �� have read and fully usiderstand and agree •to the provisions o� �t-h�.s instrumen . .The und�ssig�n,ed .states and affisms that h or she is desiraus af �onstructizig, renovatixig, addirsg to or xeroo�ing his or her own domicile, 'that he os she aetually occupies, ar wi11 accupy by said c3omica:le, and same is not �as �rent, lease or sale. Tha'� he ar she shal comply wi-th the fo�.lowiizg cc�n,3i-tions: 1. �`ha.�, the awnes aac3_he or she alone sh � 1 aat as -�he buildc�x fas a1�. phases o� construc�ion. - 2. �ha� the ownes wi:�.l comp3y with aI1: p avisions af �the City af Zephyrhil'ls orda.rlances arid dodes pertinent to the�buildirig. , 3, �hat in the event various phases ot c nstruct.ion are subcoatracted, he wi11 engage only •propesly 1.icexised subeon actors and will personal�.y supervise such work. 4. fiha-� 3 n the event the BuiZdiag =nspea ox sh�11 requs.re cosrec�3.ans to be made, -the owne.x wi11 assume full responsibi ity to insure •tb.ey are made, and upon campletian w�.11. ca13. for a re;ri�ecti. n befose praaeecling with t�ie building. 5. Tha� the ownes sha11 assume ful.2 resp ns'ibility f'or the construction asxd wi3.1 not expect_ supesvisioa of his work fr the City .of Zephyrhills Building D�part�ezxt. 6. 2'ha� prior ta firxal inspection aay a '�3.on�. fees, iriclucling zeinspecta.on f�es, must be paid ixi full.. A writt r�quest from this office shall constitute ain off�.cia]. not�.ce `�o pay �ditional. �ees.. 7. �ha�. the ownes shall comply with a11 'ty, State and Federal laws �.n re�'drd to soc.�.a1 seaurity, workman's ao�apensati n, 1i�n lavas, etc. , whexe applicab2a. B. Tha� the owner s�s�11 comply wi.th all �e safe.ty codes issued by the Flosida ISIC�CIS�'S'3.� C.`OID�1SS14A. 9. State 1aw rern�i res cosiststizcti.axa to b � done by licensed contractors. You have applied tor a pe�m3.t under ars exesap �on to that law. The ex�ptior� allows you, as the ownes af your property, c act as yout oaaa etintsactar vzith eertain restricti.ons even though you da no�G ve a license. You must .provide clirect ansa.te supervision of t3ze constructa. n yaurself. You may build or i�pxave a. oae-�am,a.ly os two-fam.i.ly resid�nce o a faxm outbuilc3.i.ng. You may also bui.l.d - or improv� a cammercial bt�.ld-issg, p=c�vided your cost.s do zxot exceed $25,000. , The bui],ding or resid�nce must be to yc�ur own use ox� oc�upancy. .2t atay aat be btii.l� or subs�ax�tially �.mproved ��r sale or l.ease. I� yon se1:l or Zease a buildiug yau have bu:i,lt ar subs�raat.i.�12y i�aproved ycurseZ�' �ri�hin 1 year aftPS the constructi.oa is campl�ate, '�he law wa.11 presume •that you built os substan�i.ally improv�d if foz sale O� �.@33Er which is a vio3at.i.on c�f this exezaptian. You may not hz.re an ua7.i��sed person to act a's your aoutraato= or to supervise people w►orking on your �ui.lding. 2t is your responsibili:�y to . make sure that people e�gloyed by yo� have licez�ses rez,;red by s�ate law and by coun�y or mun3.cip'a1 liaeasing o�d�ces. You ma.y not� delegate the respons3bility far supervising wask a licensed aantractar who i.s not. 1icn�sec3 to pertorm the wcrk be.ixzg don�. Any p�sson work.zng aa your builcliang wha is ssot lzc�,��d mus�t svorlc uside� �raur direct supervisa.on arxd must be P�pZoyed by you, which meaus t�at yo must deduat F.I.C.A. and withholding tax and provide work.ers' compEasa'�,a.on �o that �mplayee, all as pxescribed by law. You� aozYSt.rt�.etian must compZy with 2 appl3cable lawrs, orcLisiances, buildiz.�g codes, asid xoriing regzalations. OWNER'S SI�NAfiURE C��+�G(��'�Y. DA2'E , ADDRE S S r ��... PHClNE ° - � W22't2E5S � ' PEF2MMIT # s