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CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Civlc Center Plaza P.O. Box I 988 . Santa Ana, California 927A2 www.Santa-ana.org r' pba NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at n^bU CITY MANAGER Baul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL [,4aria D. Huizar 0 rlt e We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of your responsibilit,es and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will nol issue a building permit until you have read, initialed your understanding of each provision, signed, and relurned this lorm to us at our olficial address indicated. An agent ol the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signily you understand or verify this intormation. h-!1L1. I undersland a lrequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildea' building permit that erroneously implies lhat the property owner is providing his or her own labor and material personally. l, as an Owner-Builder, may be held liable and subject to serious financial risk lor any injuries sustained by an unlicensed person and his or her employees while working on my property. [/y homeownels insurance may not provide coverage for those injuries. I am willlully acting as an Owner-Builder and am aware of the limits ol my insurance coverage for injuries to workers on my property. [1A-r. I understand building permits are not required to be signed by property owners unless they are responsible for- the construction and are not hiring a licensed Contractor to assume this responsibility. / vvt ,I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. & l\-+. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. A hl U. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construclion is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and lederal law. IL A_r- I understand il I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll 1axes, provide workers' compensalion disability insurance, and contribute to unemployment compensation of each "employee." I also understand my lailure to abide by these laws may subject me to serious financial risk. c lttoA eM_7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential struclures cannot legally build them with the intent to ofler them lor sale, unless a// work is performed by SANTA ANA CIry COUNC]L moul do@santa-ana.oro Mayor Pro Tem, Ward 2 mimninez@sanla ana.oro isolono@sa.ta'ana orc P. David Benav des dbenav des@sanra.ana.ord ivilleoas@sanla-ana.oro slnaiero@santa a.a.oro I\,4AYOR MiguelA. Pulido IVAYOR PRO TEIVl Michele l\,4artinez COU NC ILIV E I\,,!B E R S P. David Benavides Vacente Sarmiento Jose Solorio SalTinajero Juan Villegas Vrente S.rm'enlo vsarmlenro@sanra-ana oro