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I\,IAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEI\,I <br />Michele Martinez <br />COUNCILME[,4BERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNINC & BUILDINC ACENCY <br />20 Civic Center Plaza <br />P.O. Box I988 . 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 ol the property <br />improvementsspeciriedut go1 lf .Sa*r-'r ClecA Aur.<rr,rtt Ava C h !'ltb <br />We are providing you with an Owner-Builder Acknowledoment and lnformation 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 ol each provision, signed, and returned <br />this form to us at our official 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: Bead and initial each statement below to signify you understand or verify this intormation. <br />0-t -Y:. I understand a lrequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel' <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. My homeowneas insurance may not provide coverage for <br />those injuries. I am willlully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />ryorkers on my property. <br />t/t -.-<"' 2. 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 />kr. ,understand as an "Owner-Buildea' I am the responsible party of record on the permit. I understand that I may <br />protect myself from potential tinanclal risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />Y?-+. t understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts.A.-'t - 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value ol my construction is al least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law. <br />///'\ 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />iederal gouernment, withhold payroll taxes, provide workers' compensation disability insurance: and contribute to <br />unemployment compensation ol each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk. <br />Wr. ,understand under Cali{ornia Contractors' State License Law, an Owner-Builder who builds singlejamily <br />residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />CIry N,4ANAGER <br />Rau Godinez ll r <br />CITY AfiORNEY <br />Sonia R. Carvalho ^CLERK OF THE COUNCIL <br />Maria D. Huizar <br />mpulido@sanla-ana.oro <br />Vrcente Sarmiento <br />vsarmrento@santa-ana.oro isolono@sanla.ana.oro <br />P. Davd Benav des <br />dbenaqdes@sanla.ana.ord lvil eoas@san16-ana.o,.sl naiero@sanla-ana.oro <br />Michele <br />^4aninezMayor Pro Tem. Ward 2 <br />mimartinez@sarla-ana.oro