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ACTING CITY I\,4ANAGER <br />Gerardo Mouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNINC & BUILDING ACENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, Califo'nia 92702 <br />www.santa ana.o.g pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property <br />improvements specified at fttS 4 Qa"-\ou- Sk 3r.*Ct"-^ CI* Qz?c 7 <br />We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of <br />your responsibilities 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 underslanding of each provision, signed, and returned <br />this form 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 ACKNOWLEDGMENT AND VERIF ICATION OF INFORMATON <br />CIIO/VS: Read and initial each statement below to signify you understand or verify this information- <br />s <br />I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />wner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensedASNU <br />person and his or her employees while working on my property. My homeowner's insurance maynot provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance cove rage for injuries to <br />kers on my property <br />I understand building permits are not required to be signed by property owners unless they are responsible for <br />nstruction and are not hiring a licensed Contractor to assume this responsibility <br />.lunderstandasan"Owner-Builder"lamtheresponsiblepartyofrecordonthepermit. I understand that I may <br />myself from potential fanancial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />d of my own <br />I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />on permits and contracts. <br />I understand rf lemploy or otherwise engage any persons, other than California licensed Contractors, and the <br />lue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />oyer" under state and federal law <br />6. I understand if I am considered an "em ployer" under state and Federal law, I must register with the state and <br />lgovernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />loyment compensation of each "employee." I also understand my failure to abide by these laws may subject me to <br />S s financial risk <br />I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />tial structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by <br />SANTA ANA C TY COUNCIL <br />Mayor Pro Tem, Wa.d 2 <br />moUidolasantd ana oro !sarmre.loaosanta ana oro isolo.io@sa.la-ana oro <br />P Orvd Benasdes <br />dbenavides@saf, la-ana oro iv eoas@santa-ana oro stinaiero@s6nta€na.o.o <br />IVAYOR <br />Miguel A. Pulido <br />MAYOR PRO TE[/ <br />Michele Martinez <br />COUNCILI\,1EMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas