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MAYOR N4iguelA. Pulido I,{AYOR PRO TEM lvlichele Martinez COUNCILIVEI\4BERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.Santa- ana.or9. 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 o We are providing you with an OwnerBuilder Acknowledqment and lnformation Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your underslanding 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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. p?__X-1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building 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. p L__d 2. 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. PP 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. fl 6. Iunderstand if Iam 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 unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. lP 7.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 a// work is performed by SANTA ANA C{TY COUNCIL ACTING CITY MANAGER Gerardo l/louet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL N4aria D. Huizar moulido@saoia ana oro Mayor Pro Tem. Ward 2 mrm6ninezrosanla ana.oro Vrcenle Sar.flento samienlo@saola-6na oro Eqbli9@sa!lai!3!!s P Dav,d Be.avides dbenav deslasanla an6.oro rvilleoaslasanl6-ana oro st naierorAsanta ana.oro lp 3. lunderstand as an "Owner-Builder" Iam the responsible party of record onthepermit. 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. ?P 5. I understand if I employ or otherwise engage any persons, other than Caljfornia licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law.