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Planning & Building Agency <br />Building Safety Division <br />20 Civic center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />Dear Property Owner <br />NOTICE TO PROPERW OWNER <br />listiAn applicati <br />specified at <br />on for a buildino oermit has been submitted in vour name <br />lf z r-' 'lrt t3roo t< I Jttt'l 1 Lrg yourself as the builder of the property improvements <br />WeareproVidingyoUwithanlomakeyouawareofyour <br />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 this <br />form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, <br />obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEGMENT AND VERIFICATIO N OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this infomation. <br />-)--^nk"r"tand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildef' build- <br />i;6rpermit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an <br />Owner-Builder, may be held liable and subJect to serious flnancial risk for any injuries sustained by an unlicensed person and <br />his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I <br />am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- <br />erty.\ <br />2. I understand building permits are not required to be signed by property owners un less they are responsible for the <br />struction and are not hiring a licensed Contractor to assume this responsibility <br />ZRif,nk"r"tand as an "Owner-Builde/' I am the responsible party of record on the permit. I understand that I may protect <br />ff\f\elt trom potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my <br />own.>- <br />-ffa I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers <br />on fermits and contracts. <br />fu und"r"tand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total <br />ffiiub of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an <br />"employer'' under state and federal law. <br />^ffirunderstand if I am considered an "employei'under state and Federal law, I must register with the state and federal <br />-!bvernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- <br />pensatlon of each "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk. <br />-4^.r/,'v 7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential <br />Sfiuctures cannot leqally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac- <br />tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract <br />with a licensed general building Contractor. <br />I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- <br />I or personal in.,uries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-c <br />APP-13 CBC 20'i6 , <br />ship or materials.