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N4AYOR Maguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinarero Juan Villegas INTERIi,4 CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.orq i oba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specifled at A We are providing you with an Owner-Bu ilder Acknowled m nt n ln rm rifi rm 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 AN D VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verifur this information. +IL1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building'pefihil lhat enoneously 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 flnancial 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. l7-LZ. I understand building permits are not required to be signed by property owners unless they are responsible for the' co struction and are not hiring a licensed Contractor to assume this responsibility. ftlS. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself' frorfi potential flnancial risk by hiring a licensed Contractor and having the permit filed in hisorher name instead of myown. HJq. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on penhits and contracts. t t /i- l-u_s. I understand rf l employ or otheMise engage any persons, other than Califomia licensed Contractors, and the total value of 'my bonslruction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employeil under state and federal law. fr-LA I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal govdrnment, withhold payroll taxes, provide workers' compensation disability insurance. and contribute to unemployment compensation ofeach "employee." I also understand my failu re to abide by these laws may subject me to serious llnancial risk. H ll . t understand under California Contraclors' State License Law, an Owner-Builder who builds single-family residential struclures 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. fl lA t understand as an Owner-Builder iflsell the property forwhich this permit is issued, lmay be held liable for any financia I or pdrsonal injuries sustained by any subsequent owner(s)that result trom any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL mou do@sema-a.a oro Mayor Pro Tem, Ward 2 mrmanrnez@sEnla 6na oro vsarm'e.ro6s3.la-anaoro 60ronc@sa.la-a.aoro dbonavrdesasanlaanaoro iv sas@sanla-ana oro str.6lero@sanr6-affi orc CITY OF SANTA ANA