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T,IAYOR <br />ft4iguel A. 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 />ACTING CITY MANAGER <br />Gerardo [,4ouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDINC ACENCY <br />20 Civic Center Plaza <br />P.O. 8ox 1988. Santa Ana, California 92702 <br />www.santa-ana.orglpba <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 />improvementsspeciriedrt lc5) -\o, R h-/, Civic C.e uv-lev Pu^, 5 N <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 />DI CTIONS: Read and initial each statement below to signify you understand or verify this information. <br />bui din <br />1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />g 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 />ers on my property <br />2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />the truction 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 />ct 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 />4. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numb;irs on permits and contracts./v'/ <br />I u,/ 5. I understand if I em ploy or otherwise engage any persons, otherthan 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 />''enlployer" under state and federal law.//'-/1Z,/ U. ,understand if I am considered an "employef' under state and Federal law, I must register with the state and <br />federal gorernrnent, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to <br />unemployment compensation of each "employee." l also understand my failure to abide by these laws may subject me to <br />s financial risk <br />7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />resldential 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 />houlido@san€-ana oro <br />Mayo. Pro Tem, Ward 2 <br />hrmatunez@santa ana.oro vsarmienlo@sanla-ana oro isororio@sanla-ana oro dbenavrdes@sanla-anaoro N eoas@sa.ta-a.aoro slhaEroiAsanla-a.aoro