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INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PI.ANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988. Santa Ana. Californra 92702 www. san ta-ana. orq / pba NOTIGE TO PROPERTY OWNER An application for a building perm jt has been submitted in your name listing yourself as the builder of the property (provements specified at5.{5 5 J 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. o NER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON RECIIONS; Read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the properly owner obtain an "Owner-Builder" building permit that enoneously impliesthatthe property owneris providing hisorherown laborand material personally. I,asan Owner- r/ 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 aslan Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2. lunderstand buildi ng permits are not required to be signed by property owners unless they are responsible for the n struction and are not hiring a licensed Contractor to assume this responsibility r' 3. lunderstand as an "Owner-Builder^ I am the res ponsible party of record on the permit. I understand that I may protect myself m potential financial risk by hiring a licensed Contractor and having the permit Iiled in his or her name instead of my own 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on its and contracts /5. I understand if I em ploy or otherwise engage any persons, other than California licensed Contractors. and the total value of construction is at least five hundred dollars ($500). including labor and materials, I may be considered an'employer" under state federal law. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal e rnment, withhold payrolltaxes, provide workers' compensation disability insurance, and contribute to unemploymentppensationofeach"employee.'lalsounderstandmyfailuretoabidebytheselawsmaysubjectmetoseriousflnancial risk I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential tures cannot legally build them with the intent to offer them for sale, unless a// work js performed by licensed subcontractors and number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed ggneral building Contractor... ,l kg. t understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or ffErsonal injuries sustained by any subsequent owner(s) that result trom any laient construction defects in the workmanship or lrh ateria ls. SANTA ANA CITY COUNCIL t,ayot tua Ten. Wa.d 2 mrman ne!@$nta-ao3 oro V'c6nre SamEnro 6am'6nro6sa.tE ana oro Lsoloro@santa ana oro P David Benavrdes dbena! des@ssnta-ana oro rvilleoas@sanla-6na qo slrnareoA'san13 ana o.. T,,IAYOR Miguel A. Pulido MAYOR PRO TEM Michele Nlartinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas Dear Property Owner: \