The URL can be used to link to this page

Home My WebLink About305 N Figueroa St - Misc. PermitMAYOR MiguelA. Pulido MAYOR PRO TEI\,1 l\,4ichele l\,4artinez COUNCILME['BERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinaiero Juan Villegas / D/ 7e 2r, crrv l,rerunc(n Raul Godinez ll CITY ATTORNEY Sonia R. Carualho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.orq/pba NOTICE TO PROPERTY OWNER Dear Propet1y Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at CA Z mou do@sarla ana oro Mayor Pro Tem, Ward 2 m mari ne2@santa ana.oro isoloio@sanla-ana oro ivi!9c{@ra!.t+e!B-cs stinaiero@santa.ana.oro 0 We are providing you with an Owner-Builder Acknowledoment and Inlormation Verilication 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 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 permit'ting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIBECTIONS: Read and initial each statement below to signity you understand or verify this information. lbl. ,. , understand a frequent practice of unlicensed persons is to have the prope(y owner obtain an "Owner-Buildei' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, may be held liable and subject to serious financial risk for any in.iuries sustained by an unlicensed person and his or her employees while working on my property. L4y homeowneas insurance may not provide coverage for those injuries. I am willlully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. -iliLr. ,understand building permits are not required to be signed by property owners unless they are responsible {or the construclion and are not hiring a licensed Contractor to assume this responsibility. ilL ,. ,understand as an "Owner-Buildef' I am the responsible party of record on the permit. t understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit Iiled in his or her name instead of my own. ll,L +. lunderstand Contractors are required by lawto be licensed and bonded in California andto listtheir license numbers on permits and contracts. lvlt'l 5. I undersland if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the total value ol my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employei' under state and federal law. h,l_Q. ,understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation ol each "employee." I also understand my lailure to abide by these laws may subject me to serious Iinancial risk. fuL,I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to ofler them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL vsardenl0@sanla ana oro P. Davrd Benavides dbenav des@sanla ana.oro licensed subcontractors and the number of slructures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. ,' i c trfl L a. t understand as an OwnerBuilder if I sell the property for which this permit is issued, I may be held liable tor any 'linancial or personal injuries sustained by any subsequent owner(s) that result from any latent construction delects in the workmanship or materials. t.,l"t( g. I understand I may obtarn more information regarding my obligations as an "employef'from the lnternal Revenue Service, the United States Small Business Administration, the Calilornia 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.oov for more information about licensed contractors. /l(- lO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legall address: y and f inancially res nsible lor pro d truc on activ at the f ollowin s l,'L ,l.l agree that. as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. /ll e.l agree to notify the issuer of this lorm immediately ol any additions, deletions, or changes to any ol the ihfoFmation I have provided on lhis lorm. Licensed contractors are regulated by laws designed to prolecl the public. ll 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 ol a complaint. Your only remedy against unllcensed 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 OwnerBuilder and wish to hire Contactors, you will be responsible lor verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Belore a building permit can be issued, this form musl be completed and signed by the property owner and returned to the agency responsible for issuing the permit. /Vote,' A coDv of the Dropertv owner's driver's license, torm notarization. or other verilication acceDtable to the aoen c v ,s reou ired to be Dresented when the Dermit is Signature ol Property Owner Print name of Owner Date:20 2.o / mt"l Lq h AUTHORIZATION OF AGENT TO ACT ON PROPERTY 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 proiect. Scope of Construction Project (or Description of Work) Name of Authorized Agent Address of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled oul the above information and certify its accuracy. Property Owner's Signature Date Print Name of Owner: Note: A copy ot the owner's driver's license, lom nota zation, or other veritication acceptable to the agency is required to be presented when the pemit is issued to verily the prope,ly owner's signature. SANTA ANA CITY COUNCIL mour do@sanla-a.a.oro Mayor Pro Tem, Ward 2 m man ne2@sanla-ana.ord Vr.erre Sarmienlo vsarm enlo@sanla-ana.oro Boloro@sanla'ana oro dbenav des.asafla ana oro iv lleoas@santa'ana oro $D3iei!@la!la:a!3.qc Project Localion or Address; Phone Number of Authorized Agent: