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IVAYOR <br />Miguel A. Pulido <br />MAYOR PRO TEI\,,I <br />Michele l\.4artinez <br />COUNCILIVEI\,IBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Viliegas CITY OF SANTA ANA <br />PLANNING & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. Box I 988 . Santa Ana, California 92702 <br />www.santa-ana.orglpba <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 <br />WeareproVidingyoUwithantomakeyoUawareof <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. <br />OWNEB'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this intormation. <br />(D . I undersland a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />buildinq 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 linancial 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 />l-------2. I understand building permits are not required to be signed by propeny owners unless they are responsible for <br />the construction and are not hiring a licensed Contractor to assume this responsibility. <br />1,,' 3. I understand as an "Owner-Builder" Iam the responsible party ol record on the permit. Iunderstand that Imay <br />[roFa myself from potential tinancial risk by hiring a licensed Contacor and having the permit filed in his or her name <br />instead of my own. <br />L=. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />5. I understand il I employ or otherwise engage any persons, other than Calirornia 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 />"employer" under state and federal law. <br />i4 | understand if I am considered an "employei' under slate 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 ol each "employee." I also undersland my failure to abide by these laws may subject me to <br />serious financial risk. <br />4. ,understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily <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 />vsarmrenlo@santa ana.o.o isolor o@santa.ana.oro dbenavLdesrasanla.ana.oro <br />CITY MANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLEBK OF THE COUNCIL <br />N4aria D. Huizar <br />0-cdr!9@sada:a!e.qq <br />Mayor Pro rem, Ward 2 <br />m madrnez@santa'an6.oro iv lr6.as@sania-ana.orc sInaiero@sanla-ana.oro <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.