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CITY MANAGER <br />Raul Godinez ll <br />CITY ATIORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDINC AGENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, California 92702 <br />www.santa-ana.org/Pba <br />NOTICE TO PROPERW 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 0 <br />We are providing you with an OwnerBuilder Acknowledament and lnformation Verification Form to make you aware of <br />your responsibiliiies 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 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 IN FORMATON <br />DTRECTTONS: Read and initial each statement below to signify you understand or verify this information. <br />Al-'l A< I understand a frequent practice of unlicensed persons is to have the prope(y owner obtain an "Owner-Builder" <br />Biilding permit tfrat erroneously implies that the property owner is providing his or her own labor and material personally. I, <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 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 />[B-Z I understand building permits are not required to be signed by property owners unless they are responsible for <br />tfre construction and are not hiring a licensed Contractor to assume this responsibility. <br />ltUS. lunderstand as an "Owner-Builder" lam the responsible party of record onthe permit. I understand that I may <br />ffotec-t mysetf from potential financial risk by hiring a licensed Conlractor and having the permit filed in his or her name <br />instead of my own. <br />OUq I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />dumbers on permits and contracts. <br />DL, I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />iffil vatue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law. <br />fiLe t understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />i&eral government, withhold payroll taxes, provide workers' com pensation disability 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. <br />\)\? <br />rebiden <br />moulido@sanra-ana.oro <br />Mayor P.o Tem, Ward 2 <br />mrmaninez@santa-zna.oro <br />vi.enre sarmienl0 <br />vsamonto@sa.la ana.oro <br />. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />tial 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 />isdar!9@s!!E:e!! pls lvilleoas@sa.ta-ana.orodbenavdes@sa.la.ana oro sli.aero@sanla ana.oro <br />MAYOR <br />Miguel A. Pulido <br />[,4AYOR PRO TEIVI <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas