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MAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCTLT,4EMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />INTERIM CITY MANAGER <br />Cynthia J. Ku.E <br />CITY ATTORNEY <br />Sonia R- CaNalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizar <br />PI.ANNINC & BUILDING AGENCY <br />20 Civic Center Plaza <br />P.O. 80x I988 . Sanra Ana. Calrfornra 92702 <br />www.Santa-ana.orq, pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application for a building permit has been submitted in your name listing yourself as the builder of the property <br />imorovements soecified at ^\') 1\E9vs Re:rJ <br />-/- We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder <br />We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned <br />this form to us at our offacial address indicated. An agent of the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />frr <br />!g=X. I understand a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner-Builder" building <br />perriit that enoneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner- <br />Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her <br />employees while working on my property. My homeowneas insurance may not provide coverage for those injuries. I am willfully acting <br />as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. <br />\J A I understand building permits are not required to be signed by property owners unless they are responsible for the <br />construction and are not hiring a licensed Contractor to assume this responsibility..\ \)t J Y3- I understand as an 'Owner-Builder" I am the responsible parly of record on the permit. l understand that l may protect myself <br />from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. <br />rr. \F +. tunderstand Contractors are required bylawto be licensed and bonded in Califomia and to list their license numberson <br />permits and contracts. <br />Sl tp. tunderstand if I employ or otherwise engage any persons, other than California licensed Contractors, andthetotal valueof <br />my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state <br />and federal law <br />-]A-)-\A I undersland rf I am considered an 'employer' under state and Federal law, I must register with the state and federal <br />government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment <br />compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk. <br />\ I .4J undersland under California Contractors' State License Law, an Owner-Builder who builds single-family residential <br />stitctures cannol legally build them with the intent to otfer them for sale, unless a// work is performed by licensed subcontractors and <br />the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed <br />general building Contractor./<-^\- <br />\JH <br />pelYonal <br />materials <br />Mayor Pro Tem. Ward ? <br />I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any flnancial or <br />injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or <br />SANTA ANA CIIY COUNCIL <br />m!!hdoosanra-ana o.o <br />v cente Sam'enro <br />6amrenloasanra-.n. oro E9h@@r@la:@4a!9 dbenav'desAsanra-a.aoro v'lle.as@$nta-anaoro sr'.aerc,Osa.raa.aoro <br />CITY OF SANTA ANA