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MAYOR <br />MiguelA. Pulido <br />MAYOB PBO TEM <br />Michele Marlanez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicenle Sarmienlo <br />Jose Solorio <br />SalTinajero <br />Juan Villegas 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.org pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application lor a building permit has been submitted in your name listing yoursell as the builder ol the property <br />improvements specified atzz <br />ACTING CITY t\4ANAGER <br />Gerardo Mouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLEBK OF THE COUNCIL <br />Maria D. Huizar <br />P- - 4-A<' 4"-1?-1 <br />mpulido@snta-ana oro <br />Mayor Pro Teh. Ward 2 <br />m'rorl ne2@s.la-ana oro !X89tt@l3!lit4qi.9rc slrneo@snt.-ana-oio <br />We are provid;ng you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware o{ <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 understanding of each provision, signed, and returned <br />this form to us at our otficial address indicated. An agenl of the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval ol the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Bead and initial each statement below to signify you underctand or verity this intomation, <br />a6 1 . I understand a frequenl practice ol unlicensed persons is to have the property owner obtain an "Owner-Builder" <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 serious 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 lor <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limils of my insurance coverage for injuries to <br />workers on my property. <br />& 2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />the construclion and are not hiring a licensed Contractor to assume this responsibility. <br />Af> 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />protect myself from potenlial financial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />AG 4. I understand Contraclors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />.a6 5. I understand il I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value of 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 />A6 6. I understand il I am considered an "employer" under state and Federal law, I must register with the state and <br />lederal 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 />& 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <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 />verm,enro@sa.ra.ana oio rsolondasanla ana o.o dbenav des@sa.la.ana oro