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MAYOR MiguelA. Pulido MAYOR PRO TEM Machele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinaje.o Juan Villegas INTERIM CITY MANAGER Cynthaa J. Kurt CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PI.ANNINC & BUILDINC AGENCY 20 Civic Cenrer Plaza P.O. Box I988 . Santa Ana, Californra 92702 www.santa-ana.orq lpba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in r name listin g yourself as the builder of prope rty improvements specified at 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 DIRECIIOAIS: Read and initial each statement below to signify you understand or verify this information.,)- "aafu I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building l-pffiit 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 nol provide coverage for those injuries. I am willfully acting as an r-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property I understand building permits are not required to be signed by property owners unless they are responsible for the on and are not hiring a licensed Contractor to assume this responsibility ,I understand 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,a I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on permits and contracts nderstand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of m nstruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and gleral law. (6. I undersland 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 of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. l)]i. I undersland under California Contraclors' State License Law, an Owner-Builder who builds single-lamily residential st#ures 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 gen eta ilding Contractor erstand as an Owner-Builder if I sell the property for which this permit ls issued, I may be held liable for any flnancial or linjuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or SANTA ANA CITY COUNCIL Ir,kyor fto Tem, Ward 2 vsamrenl.asa.la an3 0ro 6cronc6sa.r. a.a cro P Davrd Eenav d6s dbenav,d6Osanla ana oro Eile9ll@$4a-fleelq snnaEro@sa.ta-ana so ,,.) materials.