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-y:'Plann ing & Building Agency Building Safety Divis ion 20 Civic C enter Plaza P.O. Box 1988 (M.19) Sa nta Ana, CA 92702 (714) 647-5800 www.santa-ana.otg APP.13 CBC 2016 NOTICE TO PROPERW OWNER Dear Property Owner An application for a build ng permit has been submrtted in your name listing yourselF as the builder of the property improvements specafied at We are providing you with an Owner-Bu lder Acknowledoment and lnformation Veriflcation Form to rnake you a,,vare of your responsibilities and possible risk you may incur by having this permit issued in your names aS the Owner-Builder U/3 will not issue a build ng permit until ycu have read. rnrtialed 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. o CK LEGMENT AND V CAT ON F NFO T D/RECflOTVS: Read and initial each statement below to signify you underctand or verify this infotmation _1 I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build- ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, may be held liable and subject to serious financial risk for any inluries 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 prop- erty _z 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. _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 potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. _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. _5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. 6. I understand if I am 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 com- pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. _7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac- :ors and the number of structures does not exceed four within any calendar years or all of the work is performed under contract /vith a licensed general building Contractor. _8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- :ial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- )hip or materials.