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8. I understan d as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any tt ancial or personal injuries sustalned by any subsequent owne(s) that resul t from any latent construction defects in theworkmanship or mat erials 7n ,t ,199ftt?19 I may obtarn more information regarding my obtigations as an 'employei' from the lnternat Revenueservlce, the united States Small Business Administralion, the California Department of Ben;fit payments, and thecalifornia Division of lnduskial Accidents. I also understand I may contact ti.re california contractors, State License Board(CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors.-"rt\,/ 10 I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I amthe party legally and financially responsible for proposed conskuction activity at the following address: 11 J agree that, as the party legally and financially responsible for this proposed construction activity, I will abide byble laws and requirements that govern Owner-Builders as well as employers.all applica 12 la gree to notify the issuer of this form immediatery of any additions, deletions, or changes to any of the I have provided on this form.tn rmation Licensed contractors are regulated by laws designed to protect the public. lfyou conlract with someone who does not have a licensethe contractors' Slate License Board may.be unable lo assisl you wrlh any financiat loss you may sustain as a reiult of a complaint.Your only remedy against unlicensed Contraclors may be in crvil courl. tlis also important for you lo understand that jf an unlicensedContractor or employee of thal individual or. firm is jnjured while working on your property, you may be held liable for damages. lf youoblain a permit as owner-Builder and wish to hire Contaclors, you will 5e reiponsible fo; v;rifying-whether or not those conlraclors areproperly licensed and the status of their workers, compensation ins!rance coverage. Before a buildi ng permit can be issued, this form must be completed and signed b y the property owner andreturned to th e agency responsible for issuing the permit. Note A co ov of the proDertv owner's driver's licen sform n e,otarization. or o ther verification cceptable to th e aoencv is reo uired to be Dre sented when the it lsissuedthener's s n Signature of Property Owner '-MEMEER Oate. 6 t 1 3 t20'17 Print name of Owner 822 S. TOWNSEND LLC AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding lhe Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby aulhonze thefollowing person(s) to act as my agent(s) to apply for, sign, and file the documenta necessary lo oblain an owner-builder permit for myproject. Scope of Conslruclion Project (or Descriplion of Work): AMAN OESIGN, tNC Project Location or Address: 822 S. TOWNSENT STREET, SANTA ANA CA 92701 Name of Authorized Agent: ALI AlVlANl Address of Authorized Agent:_ Phon6 Number of Authorized Agent: 949-45&1091 ldeclare under penally of pe u al. l-a m .the.e rty owner for the address lisl ed above and I personally lllled out the aboveinforrnation and certify its a cc Property Owner's Signature [.lEt\rBER Oale:6/1 3/201 7 Prinl Name of Owner: 822 S TOWNSEND LLC Note: A copy of the owner's d vet's license, form notarization, or othet verification acceptable to the agency is rcquired lob6 presented when the pemit is issued to ve ly the property owner's signature. PLrnk WP-q 1/Co r.reracrv'ly/A s1e6ur/ Erth/Nor (s 'r Prof,p y Forn SANTA ANA CITY COUNCIL moulido6s.ta-gn! oro Mayor Pro T.m, W.,d ?m'@liezosla-mr o.o L3armrsrol6sa(E-@ dd r$loriod!s.^l...na (o s[oi.fi!!!je!3q!:!!!,eq N,[oosr@ranl. aE qo 3leido@selore do