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I\,4AYOR <br />[,4iguelA. Pulido <br />I,IAYOR PRO TEI\,1 <br />[,4ichele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicenle Sarmiento <br />Jose Solorio <br />SalTinalero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNINC & BUILDING 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 property <br />improvements specified at )AA <br />CITY MANAGEH <br />Raul Godinez ll <br />CITY ATTOHNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />[raria D. Huizar <br />Z 0 <br />We are providing you with an OwnerBuilder Acknowledoment and Inlormation Verification Form to make you aware of <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 until you have read, initialed your understanding of each provision, signed, and returned <br />this form to us at our oJficial address indicated. An agent of 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 VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signity you understand or verify this information, <br />V* l. I understand a frequent practice ol 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 lor 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 of my insurance coverage for injuries to <br />workers on my property. <br />Vll z. I understand building permils 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 />lrtl S. lunderstand as an "Owner-Buildea' I am the responsible party ol record on the permit. I undersland 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 ol my own. <br />l/t-L. I understand Conractors are required by law to be licensed and bonded in California and to |ist their license <br />numbers on permits and conlracts. <br />-Vt-5. t understand if I employ or otheMise engage any persons, other than Calilornia 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 />"employea' under state and federal law. <br />/lLA. I understand il I am considered an "employer" 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 lailure to abide by these laws may subject me to <br />serious f inancial risk. <br />Vll l. I understand under California Contractors' State License Law, an Owner-Builder who builds single{amily <br />residential structures cannot legally build them with the intent to oller them for sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />[o4lido@sada:ala,-Qlc <br />[r].hel.,a lrarl nez <br />Mayo. Pro Tem. Ward 2 <br />mimarline2@sanla-a.a oro <br />Vicenre Sarmrenro <br />vsa.m enlo@sanla-ana oro soloro@sanla.ana.oro <br />P. Davd Benavides <br />dbenavrdes@santa.ana.o.o ivilleoas@sanla-ana.oro siinaiero@sanra'ana.oro