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MAYOR <br />Miguel A Pulido <br />MAYOR PRO TEM <br />Vincent F. Sarmiento <br />COUNCILMEMBERS <br />Anggllca Amezcua <br />P. David Benavidos <br />Mrch€la Maninez <br />Roman Reyna <br />SalTrnalero CITY OF SANTA ANA <br />PLANNING & BUILDINC AGENCY <br />20 Crvrc Center Plaza <br />P.O. Box I988 . sanra Ana, Calrfornia 92702 <br />www.santa-ana.org 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,*r:r"l*,. specified ^, ,lr, Z w Llh ,iV<€T <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. <br />We will not issue a building permit until you have read, initialed your understanding of each provision, signed. and returned <br />this form to us at our official address indicated. An agent of the owner cannot execute this nottce unless you, the property <br />owner. obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF I NFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information <br />1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />building permit that enoneously amplies that the property owner is providing his or her own labor and material personally. I <br />as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for <br />those iniuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />workers on my property. <br />U-Z I understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are not hinng a licensed Contractor to assume this responsibility. <br />Qt. 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 haring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />*O I understand Contractors are requrred by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />4U. I understand if I employ or orherwise engage any persons, other than California licensed Contractors. and the <br />total value of my construction is at least five hundred dollars ($500), including labor and materials. I may be considered an <br />"employea' under state and federal law. <br />4U I understand if I am considered an "employer" under state and Federal law. I must register with lhe state and <br />federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk. <br />'& I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by <br />licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is <br />performed under contract with a licensed general building Contractor. <br />SANTA ANA CITY COUNCIL <br />A^gdrca &rP-:@ <br />MAn'doio.rnra-3na do <br />vrrcar F 5€m6do <br />Mavo, Pro I.n' Wao i <br />Vs€me.lott5a.rr.!@ dc rrqralFozae.ta .na do <br />C{TY I\IANAGER <br />Davrd Cavazos <br />CITY ATTORNEY <br />Sonra R Carvalho <br />CLERK OF THE COUNCIL <br />Mafla D. Hupar <br />AAhacu.@sanra'ana do O8.nay6€s6,sanb.ana d. RR.faO3anra-sna d! Sl6!soos!nr.{.6 yo