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MAYOR <br />MiguelA. Pulido <br />MAYOB PRO TEM <br />Machele l\,4artinez <br />COUNClLlr.4E[,lBEBS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNING & BUILDING ACENCY <br />-10 ( rvrr ( enter Pli7, <br />P.O. Box 1988 . Santa Ana. California 92702 <br /> / pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application for a building permit has been submitted in your name listing yoursell as the builder of the property <br />improvements specitied u, tItZ N. coc: tg€ ST: <br />We are providing you with an Owner-Builder Acknowledoment 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 Owner-Builder. <br />We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned <br />this lorm 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 VERIFI CATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signity you understand or verity this intormation. <br />$ ,. ,understand a frequent practice oI unlicensed persons is to have the property owner obtain an "Owner-Buildei' <br />building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an Owner-Builder, may be held liable and subject to serious financial risk lor any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. lvly homeownels insurance may not provide coverage {or <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />workers on my property. <br />A ,. , understand building 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 />4h , , understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />prbtect mysell 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 />(VA o. ,understand Contractors are required by law to be licensed and bonded in Calilornia and to list their license <br />numbers on permits and contracts. <br />U-U. t 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 ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law. <br />4[-U. <br />' <br />understand il I am considered an "employel'under state and Federal law, I must register with the state and <br />federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />unemployment compensation of each "employee." I also understand my failure to ablde by these laws may subject me to <br />serious linancial risk. <br />,t$ , <br />' <br />understand under California Contractors' State License Law, an Owner-Builder who builds singlejamily <br />re:sidential structures cannot legally build them with the intent to ofler them lor sale, unless a// work is performed by <br />CITY MANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLEBK OF THE COUNCIL <br />Maria D. Huizar <br />mool do@santa-ana.oro <br />Mayor Pro Tem. Ward 2 <br />mimanrne2@santa ana oro <br />Vlcenre Sarmiento <br />'ana oro €oloro@sanla.ana.oro dbenavdes@sanla ana.oro jyiXeqa!@Sada:a!@ sr naoroaasanh ara ord <br />SANTA ANA CITY COUNCIL