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Pl.nning & Buildlng AgoncY Bullding S.f.ty Divl.ion 20 Clvic Contcr Pl.z. . . P.O. Box 1988 (M-10) s.nta Ana, cA 92702 (714) 647-5800 www.Santt-ana,olg APP,13 CAC 2016 NOTICE TO PROPERTY OWNER Oear Propeo Owner An applcation for a buildi rmit has been submitted in your n listing yourself as the builder of the property improvements specified at WeareprovldlngyouwlthantomakeyoUawareofyour 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 retumed this form to us at our otficial address indicated. An agent ofthe owner cannot execute this notice unless you, lhe property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Roed and initial each statament balow to signity you understand or verify thts lntomation. ft :-.l-!_1. I understand a frequent practice o, unlicensed pâ‚¬rsons is to have the property owner obtain an 'Owner-Builder' build- ing pâ‚¬rmit that erroneously implies that the property owner is providing his or her own labor and matsrial personally. l, as an Oflner-Builder, may be held hable and subject to serious tinancial risk for any injuries suslained by an unlicensed pe6on and his or her employees while working on my property. My homeowner's insurance may not provade coverage for those iniuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- erty. t-{-2. I understand buildrng permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume thrs responsibility. E ! g. , understand as an "OwnerBuildef I am the responsible party of record on the permit. I understand that I may protect myself lrom rctential financial risk by hiring a licensed Contraclor and having the permit filed in his or her name instead of my own. .\ -L-Ll f understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numberS on permils and contracts. +. . \-. I undersland if I employ or otheMise engage any persons, other than Califomia licensed Confactors, and lhe total value of my construction is at least five hundred dollars ($500). including labor and materials. I may be considered an 'employe/ under state and federal law. -f 'tO f understand if I am considered an "employer" under state and Federal law, I must rogister wilh the state and federal govemment, withhold payroll taxes, provide workers' compensation disability insurance, and contribut6 to unemployment com- pensatron ol each "omployee." I also undersland my lailure to abide by these laws may subjoct me to senous financial risk. E .\ 7. I understand under Califomia Contractors' State License Law, an Owner-Builder who builds singlejamily residential structures cannot legally build them with the intent to offer them for sale. unless a/l work is performed by licensed subcontrac- tors and the number of structures doâ‚¬s not exceed four within any calendar years, or all of the work as performed under contract with a licensed general building Contractor. &-A I understand as an Owner-Builder i, I sell the property for which this permal as issued, I may be held laable for any tanan- cial or personal injuries sustrained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or malerials.