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/o/?rzco <br />I,l!AYOR <br />l\,Iiguel A. Pulido <br />I,AYOB PBO IEM <br />Michele N,4artinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CIry OF SANTA ANA <br />PLANNING & BUILDING ACENCY <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 />improvements specif ied at \c\o N. Fo,\-dul n GI. S"u+o An- CA 121 <br />CITY MANAGEB <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />l\,4aria D. Huizar <br />\03 <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware ol <br />your responsibililies 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 olficial 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 />OWNEF'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signity you understand ot verily this information. <br />7-.(<' f . f understand a lrequent practice o, 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. I, <br />as an Owner-Builder, may be held liable and subject to serlous financial risk for any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. lvly homeowner's insurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware ol the limlts of my insurance coverage for injuries to <br />workers on my property. <br />.2. I understand buildin g 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 />{Sg f understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />Drotect 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 />aS o. , understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />&u. 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 />frU. , understand if I am considered an "employei' 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 of each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk. <br />j S z. t undersland 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 CITY COUNCIL <br />moulido@sanra ana.oro <br />lvlayor Pro Tem, Ward 2 <br />m han ne2(6sarta-ana.oro <br />Vrcente Sa.fiienlo <br />vsarmrenlo@sanla-ana.oro lsolor o@sanla ana oro <br />P David Benavides <br />dbenav des@sanra.ana.oro ivrlleoas@santa-a.a.oro stina 610@santa-ana.oro <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property