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1 Jr'o! MAYOR Miguel A. Pulido MAYOR PRO TEM Sal Tinajero COUNCILMEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Vincent F. Sarmiento Dear Property Owner An application for a CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE GOUNCIL Maria D. Huizar CITY OF SANTA ANA PTANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box .l988 o Santa Ana, California 92702 www. santa-ana.org / pba NOTICE TO PROPERTY OWNER it SU the buil the property improvements We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owne We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT AND VER!FICATION OF INFORMATON DIRECTIONS; Read and initial each statement below to signify you understand or verify this information. .., I. ' ! 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" Uuif Orng permit that erroneously implies that 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 for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. ." [ 2. l 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. \ rrLi ! 3 I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potentialfinancial risk by hiring a licensed Contractor and having the permitfiled in his or her name instead of my own. -!j!_4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ,'4 7i. ' L 5. I understand if I employ or othenrvise engage any persons, other than California licensed Contractors, and the t,otat vatue of my construction is at least five hundied'dollirs ($5001, including labor and materials, I may be considered an "employer" under state and federal law. h,iI L 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and feOerat government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 0 L I I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless allwork is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. lis\s