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[TAYOR <br />Miguel A. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNING & BUILDING ACENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, California 92702 <br />www.santa-ana.or9 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 specif ied at\./ /t arla E a</ro l\--) S 6flmS<,0+- S} <br />WeareproVidingyouwithantomakeyoUawareoI <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 underslanding of each provision, signed, and returned <br />this form to us at our o{ficial 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 />OWNEH'S ACKNOWLEDGMENT AND VERIFICATION OF INFOBMATON <br />DIBECTIONS: Bead and initial each statement below to signify you understand or verify this information. <br />A?( l. t understand a frequent practice ol unlicensed persons is to havethe propedy owner obtain an "OwnerBuilder,' <br />building permit thal erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an OwnerBuilder, 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 />,nL 2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />th'e construction and are not hiring a licensed Contractor to assume this responsibility. <br />,14 L 3. I understand as an "Owner-Buildea' I am the responsible party ol record on the permit. I understand that I may <br />piotect 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 />,141 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />nr"imbers on permits and contracts. <br />t? a 5. I understand il I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />tdtal value ot 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 />k4 ( 6. I understand if I am considered an "employei'under state and Federal law, I must register with the state and <br />feileral 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 />,4( 7. I understand underCalifornia Conlractors' State License Law, an Owner-Builder who builds single-family <br />residential structures cannot legally build them with the intent 1o offer them lor sale, unless a// work is performed by <br />SANTA ANA CITY COUNCIL <br />CITY MANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF IHE COUNCIL <br />[,4aria D. Hui2ar <br />Eprud!@sada:ala.llq <br />r,,layor Pro Tem Wa.d 2 <br />mmannez@sanra-ana.oro <br />Vicente Sarmiento <br />vsa.mienlo@sanla-a.a oro isoloro@sanla.ana.oro <br />P David B€navdes <br />dbenavrdes@sanla.ana.oro ivirieoas@sanra ana oro srnaiero@santa ana oro