1405 E Avalon Ave - Misc. Permit

Home Browse Search

licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under conlract with a licensed general building Q.ontractor. l- U. , understand as an Owner-Builder if I sell the property tcr which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. ^g. t understand I may obtain more inlormation regarding my obligations as an "employea'{rom the Internal Revenue Service, the United States Small Business Administration, the California Department ol Benelit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. 10. I am aware of and consent to an Owner-Builder building permit applied for in my name. and understand that I am the party ly and {inancia u:"oo n efo ,l proposed struction ity a hef lowing 9^zoaddresat/ -t-.1N _1 1. I agree that, as the party legally and financially responsible lor this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. _12.1agree to notify the issuer of this form immediately of any additions, deletions, or changes to any ol the information I have provided on this lorm. Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result ol a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as OwnerBuilder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Ivolej A coDv of the proDertv owner's driver's license, lorm notarization, or other veritication acceptable to t aoencv is reouired to be presented when the permit is s re. A-,-Signature of Property Own Dale 5 /s t0, Print name of Owner lf D\, AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) lo acl as my agent(s) to apply ior, sign, and file the documents necessary lo obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address Address ol Authorized Aoent Phone Number of Authorized Agent ldeclare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Property Owner's Signature Date Print Name of Owner Note: A copy ol the owner's driver's license, form notarization, ot other verification acceptable to the agency is required to be ptesented when the permit is issued to verify the property owner's signature. SANTA ANA C TY COUNCIL mo.l,doadsa.ta ana.oro rvayor Pro Tem. Ward 2 E!oani!e?@sa!lr:a!@ vsarm ento@sanra ana oro l$lsre@.lalla:ana4Iq P Davrd Aenavides dbenavdes@sanra ana.oro i!ne9as@!afl!:a!@ sr nalero@sa.ra ana oro I Name ol Authorized Aoenl: