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MAYOR <br />Miguel A- Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEI.4BERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />Dear Property Owner <br />An application for a building <br />improvements specified at <br />ACTING CITY MANAGER <br />Gerardo Mouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNINC & BUILDINC AGENCY <br />20 Civic Center Plaza <br />P.o. Box I 988 . Santa Ana. Califo.nia 92702 <br />www.santa- ana.org / pba <br />NOTICE TO PROPERTY OWNER <br />has been submitted in your name listing yourself as the builder of the propertypermit <br />3ol Sot -(4ur\n-U.,l-cft Lza <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 notice unless you, the property <br />owner, obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />XTRECI/OilS; Read and initial each statement below to signify you understand or verify this information. <br />IW ,. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />6'dilding permit that erroneously implies that 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 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 m y property <br />2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />nstruction and are not hiring a licensed Contractor to assume this responsibility. <br />3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />eco <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 />iN-U n understand if I am considered an "employer" under state and Federal law, I must register with the state and'federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />unemploymentcompensationofeach'employee.'lalsounderstandmyfailuretoabidebytheselawsmaysubjectmeto <br />serious financial risk. <br />Uv\411understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />res{dential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by <br />SANTA ANA CITY COUNCIL <br />moulido@sanla-ana.oro <br />Mayor Pro Tem Ward 2 <br />mifr 6rtinez@sanla ana.oro isorono@sanla-ana,oro <br />P. Oavrd 8€navides <br />dbenavides@santa-ana.o.o rvilleoasrAsanla ana oro sl .aiero@sanla-ana oro <br />instead of rly own. <br />Wif ,nO"rstand Contractors are required by law to be licensed and bonded in California and to list their license <br />humbers on permits and contracts. <br />hld <br />' <br />understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />Vicente Sa.mlenlo <br />vsarmienro@santa-ana or0