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MAYOR iriguel A. Pulido MAYOR PRO TEM Michele Ma(inez COUNCILMEMBERS P. David Benavides Vicente Sarmienlo Jose Solorio Sal Tinajero Juan Villegas ACTING CITY MANAGER Gerardo Mouel CITY ATTOBNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Dear Property Owner An application lor a building permit has been submitted in your name listing yourself as the builder ol the propert v improvements specif ied at T .+1 We are providing you wilh an OwnerBuilder Acknowledoment and lnformation Verification Form lo make you aware of your responsibilities and possible risk you may incur by having this permil issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our olficial address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGME NT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signity you understand or verify this information. -V-c|. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit thal erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held llable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may nol provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 95 z. lunderstand building permits are not required to be signed by property owners unless they are responsibte for the construction and are not hiring a licensed Contractor to assume this responsibility. L7 S. lunderstand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. fi? S I understand if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and lhe total value of my conslruction is at least live hundred dollars ($500), including labor and materials, I may be considered an "employea' under state and lederal law. LA. I understand il I am considered an "employer" under state and Federal law, I must register with the state and federal gouernment, withhold payroll taxes, provide workers' compensation disability insurancel and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk- )- resr denti I understand under Calirornia Contractors' State License Law, an Owner-Builder who builds singleJamily al structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL lBldo@sanâ‚¬ ana do Mayor P.o I6m, W.rd 2 mronrnE2(asanb'ana so V,csnte Samenlo ,sa.denro@sb ana do sobndaenla'ana.oro dbenavd*6$nra ana oro N I eoasosania.sna.oio sn.M.o@snra ana oro CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Crvrc Center Plaza P.O. Box I 988 . Sanra Ana. California 92 702 www.santa-ana.org pba NOTICE TO PROPERTY OWNER