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I\,4AYOR MiguelA. Pulido I\,4AYOR PRO TEM Michele Marlinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, Califo.nia 92702 wlvw.santa ana.org/pba NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in yo ur name lislin yoursell as the builder of the property improvements specifi at 2 s, o s9 We are providing you with an OwnerBuilder Acknowledoment 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 understanding of each provision, signed, and returned this form to us at our oflicial address indicated. An agent o{ the owner cannol execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKN WL EDGMENT AND VERIFICATION OF INFORMATON D,RECTIONS: Read and initial each statement below to signity you understand or verify this intormation. ^),n(LItt I understand a frequent praclice of unlicensed persons is to have the propeny owner obtain an "Owner-Buildei' 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. lr,1y homeowneis insurance may nol provide coverage for those injuries. I am willlully acting as an Owner-Builder and am aware ol the limits of my insurance coverage for injuries to workers on my properly. AlL, I understand building permits are not required to be signed by property owners unless they are responsibte for the construction and are not hiring a licensed Contractor to assume this responsibility. -l _. W, I understand as an "Owner-Builder" I am the responsible parly of record on the permit. I understand that I may prolect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. Clb-o I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ULU. I understand if I employ or otherwise engage any persons, other than Calilornia 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''eTployer' under state and federal law.nlr L!-U.-A. I understand if I am considered an "employer" under state and Federal law, I musl register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation ol each "employee." I also understand my failure to abide by these laws may subject me to sprious financial risk. Al, I understand under Calilornia Conlractors' State License Law, an Owner-Builder who buitds singtejamity resia-ential structures cannot legally build them with the intent to offer them for sale, unless a// work is periormed by SANTA ANA CITY COUNCIL ACTING CITY i\,4ANAGER Gerardo Mouel CITY AfiORNEY Sonia R. Carvalho CLERK OF THE COUNCIL [,4aria D. Huizar mpul do@sanIa-ana.o.o Mayor P.o Tem, Ward 2 miman nez@sanla.ana.oro V.e,rte Sarmienlo vsamrenlo@sanla ana.oro isoloro@santa.ana.oro P Davld Benavdes dbenavides@saola-ana.oro iv'lle6as@santa anaoro slinaie.o@sanla ana.oro