10183535 - Permit - Laserfiche WebLink

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MAYOR MiguelA. Pulido MAYOR PRO TEM Sal Tinalero COUNCILMEMBERS Angelica Amezcua P. David Bâ‚¬navides Michele Marlinez Roman Reyna Vincent F. Sarmiento CITY OF SANTA ANA PLANNINC & BUILDING ACENCY 20 Civic Center Plaza P.O. 8ox 1988 . Santa Ana, California 92702 www.santa-ana.org /pba An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at 5.(-.+ k_ CITY MANAGER Davad Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar 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. OWNER'ACKNOWLEGMENT AND VERIFICATI N F INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. ,fu I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" rbuilding permit 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 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 an Owner-Builder and am aware of the limits of my insurance coverage for injuries to ers on my property understand building permits are not required to be signed by property owners unless they are responsible for nstruction and are not hiring a licensed Contractor to assume this responsibility I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may tect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her namep U rns ad of my own I understand Contractors are required by law to be licensed and bonded in California and to list lheir license bers on permits and contracts tota valu I understand if lemploy or otherwise engage any persons, other than California licensed Contractors, and the e of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "e ployea under state and federal law I understand if I am considered an "employer" under state and Federal law, I must regaster with the state and eral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to NOTICE TO PROPERTY OWNER Dear Property Owner: 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. ungmployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to seious frnancial risk.t) 4 Lf I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures 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.