1307 & 1307 1%2 W Ninth St - Misc. Permit

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Plannlng & Bulldlng Agetcy Bulldlng Safoty Division 20 Clvlc conter Plaza P.O. Box 1988 (n-19) Santa Ana, CA 92702 (714) 647-s800 www.Santa-ana.org Ra APP.13 CBC 2016 NOTICE TO PROPERW OWNER oear Property owner An application for a building rmit has been submitted in r name listing yourse It as the builder of the property ents specified at We ara providing you with an Owner-Bullder Acknowledoment and lnformation Verification For.r.n to make you aware of your r"sponsibililes ind possible rEI'!6IEEy lncur by having ttris permit lssued in your names as the Owner-Builder. We will not issue a building permit untll you have read, initialed your understanding of each provision, signed, and rctumed this form to us at our officiat ad-diess indlcatid. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the Permittlng aulhority. I understand if I employ or otherwise engage any persons, other than Califomia lic8nsed Contractors, and the total my construction is at least five hundred dollars (5500). includlng labor and materials. I may be considered an DIRECTION Road and tnlttat each statement bslow to slgnw you understand or verlfy thls lnformatlon. I undeGtand a frequent practice of unlicensed pe rsons ls to have the property owner obtain an 'Owner'Builde,' build- rmit hat enoneously implies that the property owner is providing his or her own labor and material personally. l, as an r-Builder, may be held liable and subject to serious fina ncial risk for any in u ries sustained by an unlicensed person and his or her employees while working on my property. My homeowneis insurance may not provlde coverage for those inju,ies. I am willfully acling as an Owner-Buitdor and am aware of the limits of my insurance coveftlge for injuries to workers on my prop- erty I understand building permits are not required to be signed by property owners unless they are responsible for the on are not hiring a licensed Contlador to assume this responsibility I undersEnd as an 'Owner-Buildsf I am the responsib le party of record on the permlt I understand lhat I may Protect f from ntial financial rlsk by hiring a licensed contracto r and having the permlt filed h his or her name instead of my own. . I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers rmits' of t"u state and federal law. I understjand if I am consld6red an "employer" under stats and Federal law, I must rggister with the state and federal ment, wlthhold payroll taxes, provlde workers' compensation disability insurance, and contributs to unemployment com- 'amployee." I also understand my failure to ablde by these laws may subiect me to serious financial risk. . I understand under Califomla Contractors' State Liceng6 Law, an Owner-Builder who builds single-hmily resid6ntial cannot lsgally build them with the intent to offer them for sale, lnless a,, work is performed by licensed subcontrac- tors and the number of sEuctures does not exceed four withln any calendar years. or all of the work is performed under contract with a llcensed general buildlng Contraclor. /1 4lM unOerstand as an Owner-Builder if I sell the property fo; which this permit is issued, I may bs held liable for any finan- cial'or personal injuries suslained by any subsequent owne(s) that result from any latent construction defecls in the workman- ship or materlals. OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON qg0tract5. of