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MAYOR Miguel A. Pulido MAYOR PRO TEM Michele l\4adinez COUNCILMEI!!BERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PI.ANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. 8ox 1988 . Sanra Ana, California 92702 www.santa-ana.orq i oba NOTICE TO PROPERTY OWNER Dear Property Owner: AF application for a building permit has been submitted in your name listing yourself as the builder of the property irhorovements soecified at -+- I t 75 N. t-z"ve// <*. We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit 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 official 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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. SF f . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner- Builder, may be held liable 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 not 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. SF Z t understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. JF S. t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may prolect myself from potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. SF a. f understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbe rs on permits and contracts. S S. tunderstand if lemploy or otherwise engage any persons, other than Califomia licensed Contractors, and the total valueof my conslruction is at least flve hundred dollars ($500), including labor and materials, I may be considered an 'employer" under state and federal law. SF A. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious frnancial risk. F Z. f understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale. unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. F g. t understand as an Owner-Builder if I sell the property forwhich this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL moUido@sanla'atu oro Msyor Pro Tem Ward 2 m man'ne2rOsanta.ana oro V'canle Sa.mrenlo !sam'eoloosanl,a 3na oro Ed.!!9@$!1a:!!4!9 dbe.av,desasanra a.a oro v'rreoas@san|a ana o.o snnaE.o@sanla-ena oro