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MAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEM <br />Michele lvlartinez <br />COUNCILI\,4EMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNING & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, California 92702 <br />www.santa-ana.org / pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application lor a building permit has been submitted in your name listing yoursell as the builder of the property <br />improvements specified at TrtEo <br />WeareproVidingyouwithantomakeyoUaWareof <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 ol each provision, signed, and returned <br />this form to us at our oflicial 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 />DIBECTIONS: Read and initial each statement below to signity you understand or verify this intormation. <br />^/.iL-lnfg\l . t understand a trequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel' <br />duilding permit thal erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. Nily homeowner's lnsurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />workers on my property. <br />)Mr. tunderstand building permits are not required to be signed by property owners unless they are responsible for <br />th'e construction and are not hiring a licensed Conlractor to assume this responsibility. <br />M I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />ffi&t mysell from potenlial linancial risk by hiring a licensed Coniractor and having the permlt filed in his or her name <br />lnstead ol m y own <br />I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />ers on permits and contracts <br />5. I understand if lem ploy or otherwise engage any persons, other than California licensed Contractors, and the <br />o value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under stale and federal law. <br />)M. I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />i6&JEl gorernment, withhold payroll taxes, provide workers' compensation disability insurance: and contribute to <br />unemployment compensation ol each "employee." I also understand my failure to abide by these laws may subject me to <br />serious linancial risk. <br />-W, . , understand under Calilornia Conlractors' State License Law, an Owner-Builder who builds single{amily <br />rEsidential structures cannol legally build them with the intent to offer them lor sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />CIry N{ANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />moulido@sanIa-ana.oro <br />Mayor Pro Tem, Ward 2 <br />mimanrrez@santa.ana.oro vsarmie.to@saora ana oro isdsio@$da:a!!.qg <br />P David Aenavides <br />dbenav des@santa-ana.oro ivilaeoas@santa-ana.oro <br />SalTirajero <br />sllnaiero@sanb-ana.o..