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IVAYOR <br />llliguel A. Pu ido <br />MAYOR PRO TEN,4 <br />N4ichele Ma(inez <br />COUNCILI\,4EMBEBS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Vallegas CITY OF SANTA ANA <br />PLANNINC & BUILDING ACENCY <br />20 Civic Center Plaza <br />P.O. Box I988 . 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 />z-4<^J'ru- A.rJA^ <br />We are providing you with an Owner-Builder Acknowledoment and lnlormation Verification Form to make you aware ol <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder <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 oflicial address indicated. An agent ol 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 />a or verity this intormation. <br />/ N41.)l understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />f builglrg'permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />;s-s 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. lvly 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 />ers on m y property <br />2. I understand buildin g permits are not required to be signed by property owners unless they are responsible for <br />construction and are not hiring a licensed Contractor to assume this responsibility <br />. I understand as an "Owner-Builder" I am the responsible party ol record on the permit. I understand that I may <br />myself lrom potential linancial risk by hiring a licensed Contractor 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 Calilornia and to list their license <br />numbers on Dermits and contracts.----^- <br />( \@) I understand if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the <br />\otal-value of my construction is at least five hundred dollars ($500), including labor and malerials, I may be considered an <br />"em yea'under state and federal law <br />CITY MANAGEB <br />Raul Godinez ll <br />CITY ATTOF]NEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />l\,4aria D. Huizar <br />lo <br />I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />overnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to <br />mo!lido@santa-ana.oro <br />l,layor Pro Tem. ward 2 <br />m marl ne2@sarla ana.oro iv lleoas@sanla-a.a.oro stinaiero@santa-ana.oro <br />era lg <br />unemployment compensation of each "employee." I also understand my failure to abide by these laws may subjecl me to <br />serio!{thancial risk. <br />@. ,undersland under California Contractors' State License Law, an Owner-Builder who builds singleJamily <br />residential structures cannot legally build them with the intent to olfer them lor sale, unless a// work is performed by <br />SANTA ANA CITY COUNCIL <br />vsarmie.b@sanraana.oro lsoloo@santa.ana.oro dbenavdes@safta'ana.oro <br />improvements specified ^, l<1 ?- - | q 1b t_ M uF.*--oe+,1