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MAYOR <br />t,4iguel A. Pulido <br />MAYOR PRO TEt\,1 <br />Michele Martinez <br />COUNCILMEMBERS <br />P. Oavid Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />Sal Tinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNING & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, Californiag2T02 <br />www.santa-ana.org/ pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application lor a buildlng permit has been submitted in your name listing yourself as the builder of the property <br />improvements specilied at <br />I b c 5"^+.q <br />We are providing you with an OwnerBuilder Acknowledoment and lnformation Verification Form to make you aware ol <br />your responsibilities and possible rlsk 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 ol each provision, signed, and returned <br />this form to us at our oflicial address indicated. An agent ol 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 />DIBECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />ll= t. I undersland a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <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 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 ol my insurance coverage lor injuries to <br />workers on my property. <br />Er. I understand building permits are not required to be signed by property owners unless they are responsible lor <br />the construction and are not hiring a licensed Contractor lo assume this responsibility. <br />Es. I understand as an "Owner-Buildei' I am the responsible party of record on the permit. I understand that I may <br />protect 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 />lE q. t understand Contractors are required by lawto be licensed and bonded in California andto listtheir license <br />numbers on permits and contracts. <br />I C5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and lederal law. <br />T4. , understand il I am considered an "employei' 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 abide by these laws may subject me to <br />serious Iinancial risk. <br />' I 14 I . I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily <br />residential structures cannot legally build them with the intent to offer them lor sale, unless a//work is performed by <br />SANTA ANA CIIY COUNCIL <br />CITY [,4ANAGER <br />RauLGodinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />[.4aria D. Huizar <br />P Dav,d Benavrdes <br />dbenav des@sanla-ana.o.omoulido@sa.la.ana.o.o <br />Mayor Pro Tem, Ward 2 <br />m ma.line2@sanla-ana.oro <br />Vcenre Sarmienlo <br />vsarm e.to@sanla ana.oro isolorio@senla.ana oro iv lleoas@enla-ana.oro slr.aiero@sanla ana.oro