717 S Garnsey St - Misc. Permit - Laserfiche WebLink

Home Browse Search

licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is'performed under contract with a licensed general building Contractor. yn L 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. _9. I understand I may obtain more information regarding my obligations as an "employer" f rom the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benelit Payments, and the ' California Divlsion of lndustrial Accidents. I also understand I may contact the Cali{ornia Contractors' Stale License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov Ior more information about licensed contractors. 77't ( lO.l am aware ol and consent to an Owner-Builder building permit applied for in my name, and understand that I am the partylegBlly and {inancially responsible for proposed construction activity at the following q4( 11.1 agree that, as the party legally and Iinancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. l4Zlz.l agree to notily the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. 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 financial loss you may sustain as a result of 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 lirm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder 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. Belore a building permit can be issued, this form must be completed and signed by the property owner and returned lo the agency responsible for issuing the permit. Nore.' A copv of the propertv owner's driver's license. form notarization. ot other verilication acceDtable to t aqencv is required to be presented when the Dermit is issued to verifv the owner's siqnature. Signature o{ Properly Owner Print name of Owner g Date ,P t,lorr'a â‚¬ CqslrO 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 lollowing person(s) to acl as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope oi Construction Project (or Description of Work) Project Location or Address Name ot Authorized Agent Address of Authorized Agent Phone Number of Authorized Agent I declare under penally of perjury that I am the property owner for the address listed above and I personally filled out the above inlormation and cerlify its accuracy. Property Owneas Signature Date Print Name of Owner Note: A copy of the owner's driver's license,lorm notarization, or other verilication acceptable to the agency is required to be presented when the permit is issued to verify the ptoperty owner's signature. SANTA ANA C'TY COU\CIL mo!Ildo@santa.ana.oro Mayor Pro Tem. Ward 2 m man nez@sanla ana oro Vicente Sarmienro vsarm'ento@sa.la ana.oro isolor o@sanla ana oro P. Davd Benavides Juan villegas SalT,najero Ward { Ward 5 Ward 6 dbenavdes@sanra-a.aoro ivill6das@sanra-ana.oro stnaie.o@sanra'ana.oro