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INTE RI I\,1 CITY I\,4ANAGER <br />Cynthia J. KurE <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.o. Box 1988 . Santa Ana, California 92702 <br />www. san ta-an a.orq / pba <br />NOTICE TO PROPERTY OWNER <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property <br />improvements specified atL\o5il.vt-oQt>51 SotI(DA+-ra c-r>, 9L1Oe{ <br />We are providing you with an Owner-Builder Acknowledament 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 />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />Q49 l. t understand a frequent practice of unlicensed persons is to have the property owner obtain an "OwnerBuilder" building <br />permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner- <br />Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her <br />employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting <br />as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. <br />O)U(Lr. , understand building permits are not required to be signed by property owners unless they are responsible for the <br />construction and are not hiring a licensed Contractor to assume this responsibility. <br />fuv'&3 I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself <br />from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. <br />@Q+ I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on <br />permits and contracts. <br />fuVfu5. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of <br />my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state <br />and federal law. <br />t@0. f understand if I am considered an "employer" under state and Federal law, I must register with the state and federal <br />government, withhold payrolltaxes, provide workers' compensation disability insurance, and contribute to unemployment <br />compensation ofeach "employee." lalso understand my failure to abide by these laws may subject me to serious financial risk. <br />Q#kr. ,understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential <br />structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and <br />the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed <br />general building Contractor. <br />QIW A. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or <br />personal inluries sustained by any subsequent owne(s) that r;sult from any latent construction defects in the workmanship or <br />materials. <br />SANTA ANA CITY COUNCIL <br />mpu dorAsania-ana oro <br />Mayor Pro Tem, Ward 2 <br />mima.linezrosa.la-aoa oro vsarm enlo6)sania a.a oro ls!&!ie@s!!!a:a!!g <br />P. Oavid Benavides <br />dben6vidsrOs.nta ana.o.o i!l1le9?s@$da:a@ slinaiero@sanla-ana.oro <br />MAYOR <br />[,4iguelA. Pulido <br />I\4AYOR PRO TEM <br />Michele [rartinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vacente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />Dear Property Owner: