HOLD- 2201 S Ross St & 414 W Anahurst Pl - Plan

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CITY OF SANTA ANA Planning and Building Ager Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-5800 www.santa-ana.org Approved FOR PERMIT ISSUANC ',a r 2i ., AftW4 DIV NOTICE TO PROPERTY OWNER Dear Property Owner An application fora ouilding permit has been sub mitt d in your name listing yourself as the 7�� r of the property improver - specified at � S t�r S S-} �c, r We are providing you with an Owner -Builder Acknowledgment and Information 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 ,n;s form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the pnor approval of the permitting authority. OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. VA (% 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" build- ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held Fable 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. ' am willfully acting as an Owner -Budder and am aware of the limits of my insurance coverage for injuries to workers on my Dr erty. " 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for thi construction and are not hiring a licensed Contractor to assume this responsibility 3. I understand as an "Owner -Builder" I am the responsible party of re cordon the permit. I understand that I may prote myself from potential financial risk by hiring a licensed Contractor and havingthe permit filed in his or her name instead of my own. &IU4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbe r- on permits and contracts, to or otherwise engage any persons, other than California licensed ��5 I understand if I emp Y ) 9 materials, I Contractors and the total value of my construction Is at least five nd federal aw,hundred dollars ($500 , including labor and m may be considered an "employer" under state considered an "employer" under state and Federal law, I must register •,�1. (} B. I understand if I am rovide workers' compensation disability insurance, Ctrib with the -� withhold Payroll taxes, P failure to abide by these laws may and contribute to state and federa government, to ee ^ I also understand my Y subject met uric p o m pensation of each 'employee." o Seri m I y ent com- us financial risk. Owner -Builder build them with the intent to offer them for sale, unless alf work iPert builds single-f - 7, I understand under California Contractors fate License Law, an V� cannot legally s not exceed four within any calendar years, or all of the ormed b fa residential Structures Y keens number of structures � the Contractor. work is pert licensed subcontrac- tO� a �c licensed general building ormed Permit is IS'S under contr act Land as an owner-B Builder subsequent owner(s) that result from an I ed, g, I understand Y latent ec c� or ��onal inturies sustained by constructio be held liabl aterials. def is ,n h for any finan_ ship or m e warkma n-