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I\4AYOR N.4iguel A. Pulido I\4AYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinaje.o Juan Villegas INTERIM CITY I\4ANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. CaNalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I 988 . Santa Ana, Califotnia 92?02 www.santa ana.orq/pba 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 specified at J \1,c 9nrttr Aer,C (1o3 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 veify this information. NV_l. I 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. lvly homeowner's insurance may not provide coverage for those injuries. lam willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. \Nt Z. f understand building permats 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. NV.-g. f understand as an "Owner-Builder" I am the responsible party of record on the permit. I undersland 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. NL+. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. Nlt S. funderstand if lemploy or otherwise engage any persons, other than Califomia licensed Contractors, andthetotal value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. NV-U. , understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal government, withhold payrolltaxes, provide workers' compensation disability insurance, and contribute to unemployment compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk. N\t ,. ' 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 lvork is performed under contract with a licensed general building Contractor. NVg. r understand as an Owner-Builder if I sell the property for which 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 a mouhdo6sanle-ana o.o Mayor Pro Tem Ward 2 rnrlr,anrnezosan16 ana oro V,cente Samrenlo !5am'enlcasanla-ana da Ed9!@!!!E:E!!.qg P O6vd Benasdes dbenaudBasanl. ana do I