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MAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILT,lET,{BERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />ACIING CIIY 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 />PLANNING & BUILDING AGENCY <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 <br />improvements specified atantlr- Wr*€d ,QcttL W ?>rct^qrr/ <br />yourself as the builder of the property <br />/wt A,fr4 or,-a afr E L'7"\ <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 />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />.rtJ 1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />building 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 my property. <br />TtJ 2. I understand building permrts are not required to be signed by property owners unless they are responsible for <br />the construction and are not hiring a licensed Contractor to assume this responsibility. <br /><J g. f understand as an "Owner-Buitder" I am the responsible party of record on the permit. I understand that I may <br />protect myself from potential fanancial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />+-d-+. t 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 />fl S. I understand if I employ 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 />-fJ O. tunderstand if Iam considered an "employer" under state and Federal law, I must register with the state and <br />federal government, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to <br />unemploymentcompensationofeach"employee.'Ialsounderstandmyfailuretoabidebytheselawsmaysubjectmeto <br />serious financial risk. <br />-[J , , 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 />SANIA ANA C]IY COUNCIL <br />moulido@sanE-ana.oro <br />Vicenle Samienio <br />vsam ento@sanla-ana oro <br />P David Benav des <br />dbenav des@sa.la-ana oro NilleoasaOsanla-ana oro slrnaie.orAsaola ana.o.o <br />M3yor Pro Tem, Ward 2 <br />n ma.t nez@sanla-ana oro solor o@sa.ta-ana oro