1716 W Wisteria Pl - Misc. Permit

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licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. 1V 8. I understand as an OwnerBuilder if lsell the property for which this permit is issued, I may be held liable for any firiancial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. TK S. f understand I may obtain more information regarding my obligations as an "employea'from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more lnformation about licensed contractors. Ik lO.l am aware of and consenl to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: Tk f f . I agree that, as the party legally and fanancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. *7-LIZ.I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the p ermit. /Vofe; A copy of the property owner's driver's license, form notarization. or other veri fication acceDtabl'e to the aoencv is reouired to be Dresented when the Dermit is issued to verifu the owner's sionature. Signature of Property Owner Date q /2 / lq Print name of Owner Excludi followin project. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF ng the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the g person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my Scope of Construction P (or Description of Work) Project Location or Ad SS Name of Authori ent: Address of Auth zed Agent Phone Num of Authorized Agent ldeclare der penalty of perjury that I rsonally filled out the above inform n and certify its accuracy Pro Owner's Signature Date Print Name of Owner: Note: A copy of the own driver's license,form ota rization, or other ation acceptable to the agency is required to be presenled when lhe is issued ,o property owner's lure. PLink WP51 iCo0nle.Ad vrlyiAsse yB slNon.â‚¬ lc Propeny aoro C3-1 ( i6 SANIA ANA CITY NCIL the property owner for address listed above and mo!lidorasanta,ana.oro Mayor Pro Tem, Ward 2 hrmadineziosa.la ana oro vcenre Sarmiento wa.m enlo@sanla'ana.oro so oio@sanla-a.a ora dben.vdesAsa.ta ara oro iv reoas@sanla a.a oro stina e.o@sanla-an..oro