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IVAYOB <br />i.4iguelA. Pulido <br />MAYOR PRO TEM <br />Michele Madinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />CITY I\,4ANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />l\,4aria D. Huizar <br />oPerty <br />1(-rz,.-t C..-rt <br />CITY OF SANTA ANA <br />PI-ANNING & BUILDINC AGENCY <br />20 Civic Center Plaza <br />P.O. Box I 988 . Santa Ana, california 92702 <br />www.santa-ana.org, 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 pr <br />improvements specilied at ZD \). CAun-oe^l VL Sc^,wl.qzloLl <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verilication Form to make you aware ol <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the OwnerBuilder. <br />We will not issue a building permit untll you have read, initialed your understanding of each provision, signed, and returned <br />this form to us at our o{licial address indicated. An agent of the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval ol the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIR!ECTIONS: Bead and initial each statement below to signify you understand or verify this intomation, <br />l/ 't . I understand a lrequent 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. lvly homeowner's insurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware ol the limits of my insurance coverage for injuries to <br />workers on my property. <br />/-l--". I understand building permits are not required to be signed by property owners unless they are responsible for <br />'the construction and are not hiring a licensed Contractor to assume this responsibility. <br />I understand as an "Owner-Builder" I am the responsible party ol record on the permit. I understand that I may <br />rotect 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 understand Contraclors are r equired by law to be licensed and bonded in California and to list their license <br />num bers on permits and contracts <br />un derstand if I employ 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 />"em ployer" under state and federal law <br />I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />eral government, withhold payroll taxes, provide workers' compensation disabillty 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.rli <br />I /V. l understand underCalifornia Contractors' State License Law, an Owner-Builder who builds singlejamily <br />rHidential slructures cannot legally build them with the intent to offer them for sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />moulido@sanla-a.a.o.o <br />Mayor Pro Tem, Ward 2 <br />m ma.l nez@san16.ana.oro isolono@santa.ana.oro <br />P Oavid Benavdes <br />dbenavdes@sanla.ana.orc iv lleoas@sanra-Ena dro sllnaiero@santa'ana.oro <br />Vrcante Sarmie.lo <br />vsarmienlo@santa-ana.o16