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Plannlng & Buildlng Agency <br />Bulldlng Safety Dlvlslon <br />20 Clvlc Center Plaza <br />P.O. Box 1988 (M-19) <br />Sants Ana, CA 92702 <br />(71t|) 8/r7.5800 <br />wrnv.arnt!-rna.org <br />APP-'t3 CgC 20 r6 <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An appl ication for a buildin sp ermit has been submitted in our name li ng yo lf as th builder of the <br />specified at <br />tm ments <br />, <br />Weareprovidingyouwithantomakeyouawareofyour <br />responsibililies 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 this <br />form to us at our otficial address indicated. An agent of the owner cannot execute this notice unless you, the property owner, <br />obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON <br />OTRECITOIVS: Read and lnltlal each statem'nt below to slgnlfy you underctand or verlfy thls lnformatlon. <br />&. tunderstand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build- <br />lhlapermit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an <br />Owner-Builder, may be held liable and sub,iect to serious flnancial risk for any injuries sustained by an unlicensed person and <br />his or her employees while working on my property. My homeownefs insurance may not provide coverage for those iniunbs. I <br />am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- <br />erty. <br />A ,understand building permits are not required to be signed by property owners unless lhey are responsible for the <br />ionstruction and arB not hiring a licensed Conkactor to assume this responsibility. <br />@, I underctand as an "owner-Bui*er" I amthe res@nsib,b pa dy ot recoa, on the pemit. I uNerstand that t may protect <br />'llryself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my <br />o\rvn. <br />&runderstand Contractors are required by law to be licensed and bonded in California and to list their license numbers <br />on pormits and contracts. <br />& ,understand if I employ or otherwise engage any persons. other than California licensed Conkactors. and the total <br />value of my construction is at lgast five hundred dollars ($500), including labor and materials, I may be considered an <br />#,*ilffi **,,, r**;ill** ir1[fi irril.?]';ifl ri,::i'rJili'rii*Hi:"x*"H;i:l <br />pensation of each "employee," I also understand my failure to abide by these laws may subject ms to serious financial risk. <br />Z-understand under California Contractors' State License Law, an Owner-Builder who buifds singte-famiTy residen(iat <br />9lfuI[res cannot l€gally build them with the intent to offer them for sale, unless all work is performed by licensed subcontrac- <br />tors and the numbor of structures does not exceed four within any calendar years, or all of the work is performed under contract <br />d:-;;'t*;.ffi tffi',:ti"'#:iy.,T,,,r"*Tir:***',,*milr:*,'tJ*'fi :ui;Jff : <br />ship or materials.