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CITY OF SANTA ANA <br />PLANNINC & BUILDINC ACENCY <br />20 Civlc Center Plaza <br />P.O. Box I 988 . Santa Ana, California 927A2 <br />www.Santa-ana.org r' pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property <br />improvements specified at n^bU <br />CITY MANAGER <br />Baul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />[,4aria D. Huizar <br />0 rlt e <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of <br />your responsibilit,es and possible risk you may incur by having this permit issued in your names as the Owner-Builder. <br />We will nol issue a building permit until you have read, initialed your understanding of each provision, signed, and relurned <br />this lorm to us at our olficial address indicated. An agent ol the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signily you understand or verify this intormation. <br />h-!1L1. I undersland a lrequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildea' <br />building permit that erroneously implies lhat the property owner is providing his or her own labor and material personally. l, <br />as an Owner-Builder, may be held liable and subject to serious financial risk lor any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. [/y homeownels insurance may not provide coverage for <br />those injuries. I am willlully acting as an Owner-Builder and am aware of the limits ol my insurance coverage for injuries to <br />workers on my property. <br />[1A-r. I understand building permits are not required to be signed by property owners unless they are responsible for- the construction and are not hiring a licensed Contractor to assume this responsibility. <br />/ vvt ,I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />& l\-+. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />A hl U. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value of my construclion is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and lederal law. <br />IL A_r- I understand il I am considered an "employer" under state and Federal law, I must register with the state and <br />federal government, withhold payroll 1axes, provide workers' compensalion disability insurance, and contribute to <br />unemployment compensation of each "employee." I also understand my lailure to abide by these laws may subject me to <br />serious financial risk. <br />c lttoA <br />eM_7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily <br />residential struclures cannot legally build them with the intent to ofler them lor sale, unless a// work is performed by <br />SANTA ANA CIry COUNC]L <br />moul do@santa-ana.oro <br />Mayor Pro Tem, Ward 2 <br />mimninez@sanla ana.oro isolono@sa.ta'ana orc <br />P. David Benav des <br />dbenav des@sanra.ana.ord ivilleoas@sanla-ana.oro slnaiero@santa a.a.oro <br />I\,4AYOR <br />MiguelA. Pulido <br />IVAYOR PRO TEIVl <br />Michele l\,4artinez <br />COU NC ILIV E I\,,!B E R S <br />P. David Benavides <br />Vacente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />Vrente S.rm'enlo <br />vsarmlenro@sanra-ana oro