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' DISQ.OSURE ST NT .E'QR 17W2�R CZTY OF ZEPF�YRH2I:LS 'SUZLDING DEPARTMENT _� ��'Dttt �li�'�`"�l have read and ful.ly und�rstand a,zid agree •to the prov.isioas o� �thi.s instrtunen . _ .The unde.�signed .states and affirms that h ax she is desirous o£ canstructing, renovat.�.zig, adding ta ar seroofa:ag his ar hes owzx domicile, •that he or she actually occupies, or will occupy by said damic3:2e, and same is nat fa= •ren�, lease or sa1e. That he ar she sh�l camply wi-�.h the followi.zzg caaditions: 1. Tha� the owner aad,he or sb�e a7..ane sh � 1 act as the bvilder for all phases at' cans�t-sua�ion. - 2. That the owner will casaply with a11 p ovisians of �the City af Zeghyshil�.s ordinances and codes pertirieat to t.he builcli.r�g. 3. �hat in the event various phases of a nstsuc'�.ion ase subcantracted, hs will engage only •propesly ].icensed �ubcaa aators and will persanal.�.y supervise such wo=k. 4, That in the event the HuiZding �nspec or shal.l require co�sec�a.ons to be �ade, the ownes will assume full resgaassbi i�y to insvre •they ase made, and upon campleti.on will caI'Z for a reiu.�u:�pec'�i n bafare psoceeding with the biiilding. 5, fihat the ownes shal.l asswae fu3.1 resp nsibilsty for the comst�xctian aad vri7.,l nat e�peat_ supervzs�.ozs. of his work fr the Ci� of Z+�physhil�,s Building � Depa.rt�es�.t. 6, Tha�. priar ta fin�1 izzspec�i.on ax�.y a ��3.onal fees, �.ricluding seinspect3.on fees, must �.ie pai.ci in fu11. A writt seques't fsam �.s office sha1l constitute an oft�.cial noti.ce to pay idi.ts.ozxal �'ees.. 7. That. the owri�r shs11 co�,1y �ri�h aZl �y, Sta.te and Fedexal laws 3.zi reC�3rd ta . social seeura.ty, workman's compensati n, lien laws, etc. , where applicable. B. Tha� the owner shall comply wit-h a11 e safe.ty codes issued by the E'lorida Industrial Comm.issioa. 9. 5ta�e 1aw rez+,;rea canstnactio� to be doae by licensed contrac'tors, You have appliei3 �or a pexsnit uzides ari �xe�p � n to that law. The ex�ption allows you, as the owner of your proFl�x'ty, o act as yovs owu coritsactor with aertain restria�.i�ns even though yau da nat v+� a licens�. Yau must ,provide direct. onsite superv�.sioxi of the coastruc'�i. yourself. You may build or improve a one-family os twa-famti.ly resideace o a faxm outbvild�.ng. You may alsa bua.ld or �prave a aommercia2 �.izs�.ldi.zag, p� i.ded your costs do nat e.�cceed $25,000. , �he building or residence must be �'o your own use ox� occupancy. .It may no� be built or subs�tially =.mproved f sale or lease. Sf you s�.11 or lease a building you have 2�vi,lt or substan�a. ly impsoved yourself within 1 yeas at'ter the aanstruction is aamplete, the la w:i.11 preswae•that you �vilt or sul�stan�.i.a11y impsoved •if for 'sale o I+�ase, which is a viaiat�a.an of th�.s eXemptioan. You may nat hire ar� unli en�ed person to act a's yovr aontractor or to supervis� peopl,e warking on yaur 'lding. It is yaur r�sponsibility to make sure that people e�ployed by ya have ].icenses �cequired by state law and by county or muni.cipal lic�xsing or ' ces. You may not delegate the responsibil.ity far superva.sing work o a licensed coxxtractor who is not. 1io�nsQd to perform t�-ie work b�ing ne. Ax�.y person work3.ng ou your buti.ldx.rxg who is aat liaeased must wark ssnciex ac� dixect supesvision and must be P�ployed by you, which maans that yo. must dedua� F.I.C.A.. and wi'�hholcLtng tax and prov,ide wo=kess' ccmpexisation �a that �apZoyee, al1 as p�escribed by 1aw. You� construation must comply with 1 appla.cabl.e laws, ardin�nces, building codes, arid zoning regulatiaas. OWNER'S SIQS.zs.fiURE liL✓ DA�.� �d~ � °� '�� �D�ss �/t o / �r-.� -f��'• h rhr!s L � . PHONE --'oL Y�T21�BS PERM�T #