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MAYOR <br />lMiguel A. Pulido <br />IT4AYOR PRO TEI\,4 <br />L4ichele l\.4artinez <br />COUNCILMEI\4BERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PLANNING & BUILDINC AGENCY <br />20 Civic Center Plaza <br />P.O. Box I988 . Santa Ana, California 92702 <br />www.santa-ana.org/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 />rmproveme cified at9i 4 S d a-.1 s <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 official 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 ACK NOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />&K I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"'building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, <br />as an Owner-Builder, may be held liable and subject to serious financial risk for any in.juries sustained by an unlicensed <br />person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />workers on my property. <br />2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are not hiring a licensed Contractor to assume this responsibility.0]-ILS I understand as an "Owner-Builder" I am the responsible pa(y of record on the permit. I understand that I may <br />protect myself from potential financial risk by hiring a licensed Contracior and having the permit filed in his or her name <br />instead of my own. <br />0*r <br />Pv 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />nqmbers on permits and contracts. <br />n) <br />fr* S. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law.A <br />/n U I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />federal government, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to <br />unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk.Af t, t/7 <br />lJy'11 I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by <br />SANTA ANA CITY COUNCIL <br />mrurido@santa-ana oro <br />Liaycr Pro Tem Ward 2 <br />n man nez@sanla ana oro <br />Vicenle Sarm ento <br />6armientorasanta-ana.oro <br />P Davd Beralrdes <br />dben3vaes@sa.1a-ana ors iv eoas@sania ana orc stinaiero@sa.1a-ana oro <br />CI'TY [,4ANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. CaNalho <br />CLERK OF THE COUNCIL <br />lvlaria D. Huizar <br />iso oao@sanla-ana oro