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7 <br />MAYOR <br />MiguelA. Pulido <br />MAYOB PRO TEI\,4 <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinaiero <br />Juan Villegas <br />CITY I\,4ANAGEB <br />RaulGodinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNINC & BUILDINC ACENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, California 92702 <br />www.santa-ana.or9 pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application lor a building permit has been submitted in your name listing yourself as the builder ol the property <br />V'K'"I?ti'9"A Arr,lrn lv* Soni-A-u 9Zror <br />moll do@santa ana oro <br />Mayor P.o Tefi, Ward 2 <br />m m.rtrne2@sanla ana.oro <br />Vrcenle Sarmienlo <br />vsa.nienlo@santa.ana.oro isolor o@sanla.ana.oro <br />P Oavrd Benavides <br />dbenav des@santa'ana.oro <br />7\- <br />' We are providing you with an Owner-Builder Acknowledoment and lnformation Verificatlon Form to make you aware ol <br />your responslbilities and possible risk you may incur by having this permit issued in your names as the OwnerBuilder. <br />We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned <br />this rorm 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 ACKNOWLEDG MENT ANO VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this intormation, <br />I t",-V I . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "OwnerBuilder" <br />building permit that 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. My homeowner's insurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware ol the limits of my insurance coverage for injuries to <br />workers on my property. <br />V'- z. t understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are not hiring a licensed Contractor to assume this responsibility. <br />W-5. I understand as an "Owner-Buildea' I am the responsible party ol record on the permit. I understand that I may <br />protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />u- 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />nurnbers on permits and contracts. <br />L/.v 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value ol my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law. <br />C.- O f understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />unemployment compensation ol each "employee." I also understand my lailure to ab de by these laws may subject me to <br />serious f inancial risk. <br />U\Z I understand under California Contractors' State License Law, an Owner-Builder who builds singlejamily <br />residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by <br />SANTA ANA CIry COUNCIL <br />ivilleoas@sanla'anaoro slnaero@sa.taana.oro