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MAYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicenle Sarmiento Jose Solorio Sal Tinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. 8ox 1988 . Santa Ana. California 92702 www.santa ana.orq,oba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the bualder of the property improvements specified at io+g w. il tvâ‚¬ r /.- SANTT+ /+-^tA We are providing you with an Owner-Builder Acknowledoment 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. Lfi l.l understand a frequent practice of unlicensed personsisto have the properly owner obtain an 'Owner-Builder" building pdrmit 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 flnancial risk for any injuries sustained by an unlicensed person and his or her employees while working on my properly. My homeowneis insurance may not provide coverage tor 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. I in Z. I understand building permits are nol required to be signed by property owners unless they are responsible for the corstruction and are not hiring a licensed Contractor to assume this responsibility. La 3. I understand as an "Ov/ner-Builder' I am the responsible party of record on the permit. I understand that I may protect myself froln potential flnancial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my own. lp 4. I understand Contractors are required bylawto be licensed and bonded in California and to listtheir license numbers on pdrmits and contracts. l! S. I understand if I employ or otherwise engage any persons, otherthan California licensed Contractors, and the total valueof m, construction is at least five hundred dollars ($500), including labor and materials, I may be considered an'employer" under state and federal law. / / 6. I understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal f{ernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymenl compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I O 7. I understand under Cahfornia Contraclors' State License Law, an Owner-Builder who builds single-family residential s'lrlctures 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. Ln A. I understandasan Owner-Builder if lsell the property for which this permitis issued, I may be held liable for any financial or p+sonal injuries suslained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL Mayor Pro Teh, Ward 2 Vrcenre Saimrenro 6amero@sanIa ana m isolmoraslnb-a.a do P OEed Benaed6s dDgnav,dc6alsanta-ana orq pr easrasaila ana o.c