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MAYOR Miguel A. Pulido MAYOR PRO TEM Vicente Sarmiento COUNCILMEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Sal Tinajero Dear Property Owner: CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civi c Center Plaza P.O. Box 1988 • Santa Ana, Cal i forni a 92702 www.santa-ana.org / pba NOTICE TO PROPERTY OWNER CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNC IL Maria D. Huizar An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at r . J J\ . -.r-: ..L o ':1. -:1..../) l-/ -~ \CO \, ~ , (2e e~a..Y\ R Y ~ r)-r' L....-, 1 L Pt -· l_cr ·1 '-' l We are providing you with an Owner-Builder Acknowledgment and Information 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 official address indicated. An agent of the owner cannot execute th is notice un less you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON ~T/ONS: Read and initial each statement below to signify you understand or verify this information. ~ 1. I understand a frequent practice of un licensed persons is to have the property owner obtain an "Owner-Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, 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. 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 inj uries to ~ers on my property. f J!!i)__2. 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 respons ible party of record on the permit. I understand that I may protect myself from potential financia l risk by hiring a licensed Contractor and having the perm it filed in his or her name J1::8fd of my own. ( !l!!i._ 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license )J;r;}ers on perm its 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 five hundred dollars ($500), including labor and materials, I may be considered an ,?3ployer" under state and federal law. (tf/ __ 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, a nd contribute to unemployment compensation of each "employee ." I also understand my failure to abide by these laws may subject me to /.~us financial risk. (_ ~_Vt} __ ?. I understand under California Contractors' State Li ce nse Law, an Owner-Builder who builds single-fam il y residential structure s cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licen sed general building Contractor. Miguel A. Pulido Mayor JMPuli do@s anta-ana.org SANTA ANA CITY COUNCIL Vicente Sarmiento Michele Martinez Mayor Pro Tern, W ard 1 Ward 2 VSa rmie nto@santa -ana .org MMartinez@santa -a na.org Angel ica Amezcua Ward3 P. David Benavides W ard 4 Mmezcua @santa-ana.org DBenavi des@sa nta-a na.org Roman Reyna Ward 5 RReyn a@santa -ana.org Sal Ti najero Ward6 STinaiero @san ta-ana .org