1910 W Glenwood 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' '7\8. I understand as an Owner-Builder il I sell the property for which this permit is issued, I may be held liable for any fin-ancial or personal injuries sustained by any subsequent owner(s) that result from any latent construction delects in the workmanship or materials. .23 I understand I may obtain more information regarding my obligations as an "employei'from the lnternal Bevenue Service, tne Unlted States Small Business Administration, the California Department ol Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-8OO-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. 3:1O I am aware of and consent to an OwnerBuilder building permit applied for in my name, and understand that I am the party I address: egally and financially responsible for propo sed construction activity at the lollowin A '%f1 I agree that, as the party legally and frnancially responsible ror this proposed construction activity, lwill abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 'kl2.l agree to notify the issusr of this form immediately of any additions, deletions, or changes to any of the inlormation I have provided on this {orm. Licensed contractors are regulated by laws designed to protect the public. lf you contract wilh someone who does not have a license, the Contractrcrs' State License Board may be unable to assist you with any financial loss you may sustain as a resull of a complaint. Your only remedy against unlicensed Contraclors 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 6e iesp'onsible for verilying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building p ermit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Arote:A coDV of the proDertv owner's driver's license. form notarization or other verification to the aoencv is uired to be Drcsented when the Dermit is issued to verifv the D owner's sionature. Signature of Property Owner Date 4 --r) " /4 Print name of Owner -\n(( (, â‚¬ A/to R l:r r AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the lollowing-person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner Builder Permit ior my project. ScopeofconStrUctionProject{orDescriptlonolWork): Project Location or Address Name ol Authorized Agent Address of Authorized Agent:-- Phone Number of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally f lled out the above information and certily its accuracy Property Owneas Signature Date Print Name of Owner Note: A copy ol the owner's driver's license, torm notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verity the property owner's signature. SANTA ANA CITY COUNCIL mpulido@sanra'ana.oro [,layor Pro Tem, Ward 2 m ma.l nez@sanla ana oro vrcente Sarmiento vsarh e.to@santa ana.oro lsd!i!@!3!l!:a!i P D.vid Aenavides dbenavrdes@sanla ana oro iv leoas@santa.ana.oro !]r!eie!!@s!!ta:e!a9!g