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MAYOR <br />Miguel A. Pulido <br />IVAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEI,lBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />Sal Tanajero <br />Juan Villegas <br />ACTING CITY MANAGER <br />Gerardo lrouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDING ACENCY <br />20 Civic Center Plaza <br />P-O. Box 1988 .santa Ana, California 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 you rself as the builder of the property <br />improvements specified at <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 agentofthe 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 signify you understand or verify this information. <br />fr\f -U t . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildefl <br />building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an OwnerBuilder, 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 injuries. 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 />1,0 , , understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are not hiring a Iicensed Contractor to assume this responsibility. <br />[,0 4 ,understand as an "Owner-Buildei' l am the responsible party of record on the permit. I understand that I may <br />plot6ct 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 />f,Lo. , 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 />[,I t ,understand if lemploy or otherwise 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 />"employer" under state and federal law. <br />[.Lu. <br />' <br />understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />lederal 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 />f ' [) Z f understand undei' California Contractors' State License Law, an Owner-Builder who builds single-family <br />resfdential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by <br />SANTA ANA C]TY COUNCIL <br />moulido@sanla-ana oro <br />Mayor Pro Tem ward 2 <br />m man .e2@sa.la-ana o.o <br />vi.e.re samienro <br />vsamienlo@sanla-ana oro soloao@sanla-ana oro <br />P Drvld Benavides <br />dbenavides@sanla-ana.oro ivilleoas@sanla-ana.oro sli.aierc@santa-ana.oro