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4 � I S ' DISCLQS S�ATEI�NT .FOR ClWZ�R . C2TX OF ZEP 2T.�.5 BLJII.DING LIEPAR�MENfi �, � � have read and fu.1.1y understand and agsee •ta the" prcrvisi.ons of �tha.s in trument. .The undersigned .states and af�'irms tha� he or she is desirous o£ constructiag, reriovat.ing, adding �to or 2eraofing his or her own domici.le, that he os she ac�ual3.y occupies, or will occupy said domiczle, 'and same is not for �resYt, lease or sa1e. That he ar s e sha11 co�p].y wi.-th the followiizg cnndi-�ions: 1. That the owsxar aad_he or she ane sha11 ac� as ~the bvilder for a7.1. phases af � constsuction. . Z. That the owzxer wxZZ co�ily wi al�. provisians a� �t�;e City af Zephyrhil.ls ordinances axid cades pertinent to '�he l�uildixig. 3. fiha� in the even� v�ious phas s of' construction are s�rcontraatad, he will eTigage only �propesly 1.icexzsed uboontractors and will pessonal.�y supervise � such wark. I 4. �hat in the even'� tlze Building 7nspectar sha11 xe�,;�se casrec'�ions to be made, the owz�er will assume full re ons�.biZi�Ly -ta insure �they are 7made, and upon � comglet�,.on wa.11 ca1l �ar a r�' ection before p=oceeding with the building. 5. That the owner shall assume f 1 respoasibility for the const�uctZ.on ax�,d wi�.1 not axpect_ sup�svisian of his ark from the Gity .of Zephy�shill.s Bzzi.lding Depart�esit. � 6. That, prior to fiss,�l i.nspection aay additional fees, including reinspecta.on fees, must be pai.d iu �full. A wri�ten x�quest from this affice shall constitute an;official no�,ice o pay additiax3al �ees.. 7. fihat 'the own�r sha11 comgl.� wi a11 City, St�ate and Fedesal Zaws i.n regard to social �eeurity, work�uan's c ensation, lie.0 laws, etc. , where applicable. 8. That the owner sha11 compZy wi. a1.1 the sa£e.ty codes issued by the Flarida Industra.al Commission. 9. State 1aw re�,;res cozastruatia to be done by li.aensed contractors. You have appliecl for a pe�mit under an e�gt�.an to that 1.aw. fihe exemptioz� a2l.ows you, as the awnes of your pro ty, to act as your ov�an coritractor w�ith aertaia ' r�strietions even though you d no'� have a lic�ts�. You must .prova.de 3irect onsi.te supesvision o� the coas c�.on yourself. You m�y bvi3.d or i.mprove a one-family or two-family sesi 'ce or a farm outbvildiag. You may also bui.,ld or improve a commercial bui1. ' g, pravi.ded yaur costs do x�.at �caeed $2�,000. , The bui].d.ing cr z�esidence�mus be tor yaur awn use or occupancy. St may nat be buiZt or siabs��anti.all.� �p ov8d for sale or lease. If you sei:1 or 3.ease a bvildiag you have .bvi.lt o�c s stant.ially improved yovsself wi�hi.a 1 year a.��,er the censtruction is comple�te, e 1aw wr3.11 presume•that ycu _built or subs�ant.ial2y improve$ if f'�r sale or Iease, whic�i is 'a violatioa af �i.s eXemption. You may nat hire unlicenaad person t� act as your cantsactoz or to supervise peop,7.e working a yaus building'. =t is you= responsibilzty ta - make swce t]a.�t people f�ploye by yau ha.ve licExases xern�i red by state law aszd by courity or mun.i.cipal licens' g ordiaances. You may not d+elegate the responsabil.a.ty far supervisin work to a Iic�nsed contractar who is not. 1ic�nsecl to perfo� t2ae warlc �asag den�. Aa�.y pexson wor]c.s.ng as� your b133.1d3.xig who is zxot 2zaena�d must work unc2�s yaur di.rect strQervision axad must be P�ployeci by you, which meaus t yau must deduct F.I.C.A. and withholding ��Y and pravide workers' comp�asa 'on for that c=�ployee, all as pzescribed by law. Yous cozxstruction must compZy with a1I applicab7.e lavrs, ardis�xices, building codes, and zoning regulatioas. . � r. ' � OWNER' S SIGZ1'ATL7RE i`� DA''L'E�, m _ ��f f„ � ADDRES � . PH02+7� / - • F{• �� PERM=T #