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Home My WebLink About1217 S Linda Way - Misc. PermitMAYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEI\,1BERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas /ot 76taz, CITY NIANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL l\,4aria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, Califorria92702 www.Sanla ana.org pb; 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 m rovemen spe cified .04, lL SANTA ANA CITY COUNCIL Mayor Pro Tem Ward 2 mima.lrner@sanla-ana oro vsarm enlo@sanra-ana ora sorono@santa-ana orc P oavd Benavides dbenavides@sanla-an6.oro p eoas@sanra-a.a oro strnaErorosanla-ana oro We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of your responsibiljties 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 notlce unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. ) )1. 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, as an Owner-Builder, may be held liable and sub.iect 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 workers on my property. -t-J:Lz. t understand building 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 this responslbility. / ) 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may "pro(ect myself from potential financial risk by hiring a licensed Contractor and having the permit filed ln his or her name instead of my own. ) ) 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license humbers on permits and contracts. .ll-S I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the(4dl vatue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. / \_A_6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and (Jb&Cral government, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 'Y-}_7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family fuAdidential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by mou doaasanb aoa oro licensed subcontractors and the number of structures does not exieed four within any calendar years, or all of the work is performed under contract with a licensed general buildlng Contractur. 8. I understand as an Owner-Builder if lsell the property for which thls permit is issued, I may be held liable for any n ncial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. t#g I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue g6d/ice, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321 -CSLB (2752)or www.cslb.ca.qov for more information about licensed contractors , Ial t0 I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am-the party legally and-finaqcially rqsponsible {or prgposed qonstruction activity at the following adoress: /?[-l s Itv.vlt l,L{\\]/ \/rtt./(lthtli fA.q1'7OL/'r-----/tVZ-7 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by al app licable laws and requirements that govern Owner-Builders as weil as employers *1 7 , J \ 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes lo any of the -rni#mation I have provided on this form. Licensed contractors are reguiated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. /Vote : A copv of the DroDertv owner's driver's license. form notarization or other verifica ,s uired to be ented when the it is issued to the w Signature of Property Owner Date Print name of Owner AUTHORIZATION OF AGENT TO ACT ON PROPERry OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address Name of Authorized Agent: Address of Authorized Aoent: Pl'one Number of Authorized Agent: Prlnt Name of Owner: Note: A copy of the owner's driver's license, form nolarization, or other verification acceptable to the agency is required to be presented when the permit is issued lo verify the propedy owner's signature, SANTA ANA CITY COUNCIL moul do@sanla-ana oro M.here Madrnez Mayor Pro Tem, Ward 2 m madrne:@sanla-a.a oro vsamre.roosa.la-a.a oro so orio@sanla-a.a.oro dbe.avrdes@sanla-ana.oro ville.asosanl6anaoro sl'.ae.oasa.raanaoro I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Property Owneas Signature: Date:_ a /olrapqt Group Design 28545 Old Town Front Street, Ste #205 Temecula, CA 92590 (ss1) 2s0-0608 April 18, 2019 Re: To Whom lt May Concern: Pursuant to your request, Group Design accepts the approved plans at the city of santa Ana for building permit number #10198209. At the time of submittal, our license was current and not expired. Due to the length of time during the approval process our licensed on the plans were out dated. our current expiration date is 2020. Please accept this letter as part ofthe building submittalfor approval. Please do not hesitate to contact our office should you have any further questions regarding information included in this report. Si AI nce yyo u rs, 'i--,.-/y des, P.EexBenavi c72968 President/Principle Cc:/File c72968 ExP. 1z/30/?o 6o tss / -* a L\(or cl <5 * Jimenes Residence 1217 South Linda Way Santa Ana, CA 92704 (Building Permit #10196209) CNIL