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MAYOR <br />Miguel A. Pulido <br />MAYOR PRO TEM <br />Claudia C. Alvarez <br />COUNCIL MEMBERS <br />P. David Eenavides <br />Carlos Bustamante <br />Michele Martinez <br />Vincent F. Sarmiento <br />Sal Tinajero <br />Dear Property Owner: <br />An application for a building permit has bee <br />improvements specified "t \?-& t--_ . q <br />CITY OF SANTA ANA <br />PLANNINC & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. Box I 988 . Santa Ana, California 92t|z <br />www.5anta-ana.org <br />NOTICE TO PROPERTY OWNER <br />n submitted in your name listing yourself as the builder of the property <br />*.<.- @*o-A !rri\ e Al Sc,...\.- $rrc" ,Q15 lzlol <br />We are providing you with an <br />your responsibrlities and poss <br />uilder kn ent and I rificati nF to make you aware of <br />ible 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 form to us at our official address indicated. An agent of the owner cannot exeiute this notice unlesJ you, the property <br />owner, obtain the prior approval of the permitting authority. <br />R'S ACKNO T AND VERIF ON OF INF TON <br />DIR NS: Read and initial each statement below to signify you understand or verify this information. <br />1. I understa nd a frequent practice of unlicensed persons is to have the property owner obtain an "owner-Builder,, <br />bu il ng permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an Owner-Builde r, may be held liable and subject to serious financial risk for any injuries sustained b y an unlicensed <br />person and his or her employees while working on my property My homeowner's insurance may not provide coverage for <br />those inj ries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />bn my property <br />I understand building permits are not required to be signed by prope rty owners unless they are responsible for <br />nstruction and are not hiri ng a licensed Contractor to assume this res po ns ibilitye <br />/,/ <br />bro(C4t m <br />lundersta nd as an "owner-Builder" I am the responsible party of record on the permit. I understand that I m ay <br />yself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her nam e <br />instead my own <br />nu <br />alue <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 />understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />under state and federal law. <br />CITY MANACER <br />Paul M. Walters <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />"employer" <br />/:--6 I understand if I am considered an "employer" under state and Federal law, I must register with the state andfeder/l government, withhold payroll taxes, provide workers' compensation disability insurancel and contribute to <br />unemployment compensation of each "employee." I also understand my failure to rbide by these laws may subject me to <br />serious fi4ancial risk. <br />,,4. I. l.understand under California Contractors' State License Law, an Owner-Builder who builds singlejamilyr6id€nlial structures cannot legally build them with the intent to offer them for sale, unless a// work is periormeo by <br />licedrsed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work isperformed under contract with a licensed general building Contractor.