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A.4AYOR <br />MiguelA. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />INTERII\,4 CITY MANAGER <br />Cynthia J. KurE <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CIry OF SANTA ANA <br />PLANNING & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. Box I988 . Santa Ana, California 92702 <br />www.Santa-ana.orq/ 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 t'na< fh 4 f</1?Cq l-z -z> <br />We are providing you with an Owner-Builder Acknowledqment 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 notice unless you, the property <br />owner, obtain the prior approval of the permitting authority. <br />R'S c DGMENT AND VERIFICATIO F INFORMATO <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />t l/\ ',. 't understand a frequent practice of unlicensed persons is to have the property owner obtain an "owner-Builder" building <br />permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner- <br />Builder, may be held liable and subject to serious flnancial risk Ior any injuries sustained by an unlicensed person and his or her <br />employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting <br />as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. <br />{/( Z. t understand building permits are not required to be signed by property owners unless they are responsible for the <br />construction and are not hiring a licensed Contractor to assume this responsibility. <br />1 f S. I undersland as an "Owner-Builder" I am lhe responsible party of record on the permit. I understand that I may protect myself <br />Irom potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. <br />{X l. I understand Contractors are required by lawto be licensed and bonded in Catifornia and to list their Iicense numbers on <br />dermits and contracts. <br />fk s. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of <br />my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/ under state <br />and federal law. <br />/ A O. t understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal <br />-government, <br />withhold payrolltaxes, provide workera' compensation disability insurance. and contribute to unemployment <br />compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. <br />'l K l. I understand under California Contractors' State License Law, an Owner-Builder who builds sjngle-family residential <br />structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and <br />the number of structures does not exceed four within any calendar years. or all of the work is performed under contract with a licensed <br />general building Contractor. <br />',,.t,/^ g. tunderstand asan Owner-Builder if lsell the property for which this permit is issued, I may be held liable for any flnancial or <br />personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or <br />materials. <br />SANTA ANA CITY COUNCiL <br />mo![do@santa-ana oro <br />[,tat6l Pi'o Td Wdd 2 <br />mrhanr.er@3a^.3-a.a o.o 6an€.ro65anra a.a oro Eorono@sanra-ana oro dbe.avrdes6sanra-..a oro M reoss,asanE-ana oro sl .aleroo $nra -ana o.o