2020 W Camden Pl - Misc. Permit - Laserfiche WebLink

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licensed subcontractors and the number of structur6s does not exceed lour within any calendar years, or all of the work is pergrmed under contract with a licensed general building Contractor./t., -aY I undersland as an OwnerBuilder il I sell the property lor which this permit is issued, I may be held liable for any linancial or personal injuries sustained by any subsequent owne(s) that result Irom any latent construction defects in the workmanshio or materials.ft" L// g. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefil Payments, and the California Division of lndustrial Accidents. I also undersland I may contact the California Contractors' State License Board (CS^LB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.r' t_/z{6.1 am aware of and consent to an Owner-Builder building permit applied lor in my name, and understand that I am th-e parly legally and financially responsible for proposed construction activity at the following address:/^/ l/ r-- | ,^-/ 11.1 agree thal, as the party legally and financially responsible lor this proposed conslruction activity, I will abide by -all applicable laws and requirements lhat govern Owner-Builders as well as employers. I agree to notify the issuer ol this lorm immediately of any additions, deletions, or changes to any of the ormation I have provided on this {orm 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 linancial loss you may sustain as a result ol 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 OwnerBuilder 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 lorm must be completed and signed by the property owner and returned to the agency responsible lor issuing the permii- Nofe.' A coDv of the DroDertv owner's driver's license. torm notarization, or othet verification acceptable to the agency is required to be presented l4belthe pelnlt ls ,s owner'.re. Signature of Property Owner Date:f -t4- tt Print name of Owner 4rtic (q C,\O{ 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 following 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 project. Scope ol Construction Project (or Description ot Work) Project Location or Address Address of Authorized Agent Phone Number of Authorized Agent Ideclare under penalty of perjury that I am the property owner lor the address listed above and I personally filled out the above inlormalion and certify its accuracy. Date Print Name of Owner Note: A copy of the owner's driver's license, torm notarization, or other verilication acceptable to the agency is required to le lresented wh:n lhe p.e:m.it !?,issued lo verify the property owner's signature. SANTA ANA C TY COUNCIL moul do@sanla'ana oro Mayor Pro Tem. Ward 2 himanrnez@sarta.ana oro vsarmre.ro@sanla ana oro isolono@sanla-ana oro P. Oavd Benavrdes dbenavides@sanla-ana.oro Name of Aulhorized Agent: Property Owner's Signature: .luan villegas saiTlnajerc Ward 5 Wa.d 6 ivilleoas@santa-ana.oro srinaiero@sanra-ana.o.o