2025 S Cedar St - Misc. Permit - Laserfiche WebLink

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lice subcontractors and the number of structures does not exceed four within any calendar years, or all of tl"D work is med under contract with a Iicensed general building Contractor 8. I understand as an Owner-Builder if I sell the prooerty for which this permit is issued, I may be held liable for any al or personal injuries sustained by any subsequent owner(s) that resull from any latent construction defects in the anship or materials. Cal . I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue , the United States Small Business Administration, the California Department of Benefit Payments, and the ia Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board ) at 1-800-321-CSLB (2752)or www.cslb.ca.qov 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 rty legally and financially respons ible for pro construction activity at the followi nOo>S C a9r l',1.1a gree that, as the party legally and financially responsible for this proposed construction activity, I will abide by Iicable laws and requirements that govern Owner-Builders as well as employers I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the ion I have provided on this form. Li sed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a llcense, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a resull of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also imporlant 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 Owner-Builder 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. Wi;re a building permit can m be completed and signed by the property owner and ned to the agency ibr rl tn e it. /Vofe; A copv of the oropertv owner's driver's license. notarization or er it issued ,o the Signature of Property Owner Date: S Print name of Owne YI w$rr*e,at TnC AUTHORIZATION OF AGENT TO CT ON PROPERry OWNER'S BEHALF Excluding the Notice to Property Owner, lhe execution of whjch I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project.Add *t"",. Ov\ $.>..s:\-rw3 \nc,vtq Nec.i.,l Aou a,rd -E wcylr. r €ed Scope of Construction Project (or Description of Work) Project Location or Address 5olS >oDs /1 6lsde., S+ S A Name of Authorized Agent; Address of Authorized Agent:( L oc) I declare under penalty of perjury for the address listed above and I personally filled out the above s /zr/r&Property Owner's Sig nature:Date: Print Name of Owner: Note: A copy of the t-,1fJnC. s s ot other verification acceptable to the agency is required to be presented when the permit is issued to the owner's signature. PLhkrwP5l/Co!nleiAclrvity^ssenuyS,lrsrNoti.e !o ProFeny Fom 03-14-?01 6 SANTA ANA CITY COUNCIL e pro e own qoul dolasa.la-ana oro M chele Marlinez Mayor P.o T€m Ward 2 mimaninez@santa-ana.oro vicenle Sarmiento 6armie.ro@santa{M.oro isolo.io@santa€na.oro P David Benavdes dbe.avrdes@sanla-a.a ora ivilieoas@sanl6-aoa oro Sal Tinajerc slinai€ro@sEnra-6na.o.o z,ft* Phone Number of Authorized Agent: information and certify its accuracy.