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MAYOR <br />Miguel A. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />CITY IV]ANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDING ACENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana. California 92702 <br />www.5anta-ana.or9/ pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property <br />tmp em nts S ecified at <br />We are providing you with an Owner-Builder Acknowledqment 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 form 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 VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information._z <br />{O. ,understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"'bIilding 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 for any injuries sustained by 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 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 />M)_r. ,understand building permits are not required to be signed by property owners unless they are responsible for <br />'th"e construction and are not hiring a licensed Contractor to assume this responsibility. <br />a4- <br />[r'f,)I Iunderstand as an "Owner-Builder" Iam the responsible party of record on the permit. I understand that I may <br />ffiect myself 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 />4. I Jnderstand Contractors are required by law to be licensed and bonded in California and to list their license <br />ers on permits and contractsU <br />5. I understand if lem ploy or otherwise engage any persons, other than California licensed Contractors, and the <br />value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />SANTA ANA C TY COUNCIL <br />mou I do@santa-ana oro <br />Mayor Pro Tem, ward 2 <br />mimarlinez@santa ana oro <br />Vrcente Sarmrenlo <br />vsarmienro@sanla-ana oro l!9Ls!i9@!!!1!:4!.9!s dbe.av des@sanla-ana.oro iv leoas@santa ana.oro sl.a eroasanla-ana.oro <br />a <br />"employer" under state and federal law. <br />t1OA. I understand if I am considered an "employer' under state and Federal law, I must register with the state and <br />lMp/al 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 />.^ /1r v./-\K[. t I . I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />teXidential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by