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MAYOR Miguel A. Pulido MAYOR PRO TEI,I Michele Martinez COUNCILMEMBERS P. David Benavades Vicente Sarmrento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at \(A"t a-^l E '.- 4z t>L 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 DIRFCTIONS: Read and initial each statement below to signify you understand or verify this information. /Zk ,understand a frequent practice of unlicensed persons is to have the property owner obtain an "OwnerBuilder' building/ pdrmil that enoneously 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 subjecl 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 not provide coverage for those injuries. I am willfully acting as 9n Owner-Builder and am aware of the limits oI my insurance coverage for injuries to workers on my property. /l-4 I understand building permits are not required to be signed by property owners unless they are responsible for the PConstruction and are not hiring a licensed Contractor to assume this responsibility. l/ 11_-, I understand as an 'OwnerBuilder" I am the responsible party oI record on the permit. I understand that I may protect myself UltrVrl polential ftnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ///-U-q. , understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on /-PeJmits and contracts./// -- 11 ys. I understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total value of /"rhy construction is at least five hundred dollars ($500). including labor and materials, I may be considered an "employer' under state and federal law. ill/ --.-///// U'6. I understand if I am considered an -employer" under state and Federal law, I must register with the state and federal /'d-ouernment, withhold payroll taxes. provide workeri' compensation disability insurance, and contribute to unemployment c7pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. /l/t U7. lunderstand under California Conlractors' State License Law, an Owner-Builder who builds single-family residential' struclures 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 gereral building Contractor. l/ il--* , 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-r'dersonal injuries sustained by any subsequent owne(s) that result fiom any latent constluction defects in the workmanship or materials. SANTA ANA CITY COUNCIL m0ul/doIos6nta-an. o.o Mayor Pro Tem Ward 2 6,nan,ne:6'sanl, ana orc v,ce.t6 Samrenro 6amrenloasanta-a4a o.a lsdMoAsante-ana do P DrMd Bâ‚¬naedes dbenav desOsEnra ana.oro Mleas@sa.t6-a.a do slrnae.oasanh ana o.o INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL lvlaria D. Huizar PI.ANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I988 . Santa Ana, California 92702 www.santa ana.orq,/gba