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Home My WebLink About1017 N Logan St - Misc. PermitMAYOR MiguelA. Pulido MAYOR PRO TEM Michele l\rariinez COUNCILIVEI\,4BERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.orglpba 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 improvements specilied at 22 a/ CITY I,4ANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL l\,4aria D. Huizar We are providing you with an Owner-Builder Acknowledoment and ln{ormation 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 OwnerBuilder. We will not issue a building permit until you have read, initlaled your understanding of each provision, signed, and returned this form to us at our olficial address indicated. An agent of the owner cannot execute this notice 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 signity you underctand verify this information. _b 1 . I understand a lrequent 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. I, 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 lor those injuries. I am willfully acting as an Owner-Builder and am aware of the limits ol my insurance coverage for injuries to workers on my property. :.r84. I understand building permits are not required to be signed by property owners unless they are responsible tor the construction and are not hiring a licensed Contractor to assume this responsibility. ' SLr. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may p"rotecl myself from potential financial risk by hiring a licensed Contractor and havlng the permit filed in his or her name instead of my own. tl-Zq. I understand Contractors are required by law to be licensed and bonded in Calilornia and to list their license r{umbers on permits and contracts. t--ZS. tunderstand if I employ or otherwise engage any persons, other than California licensed Contractors, and the t'otal value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. . I understand if I am considered an "employer" under state and Federal law, I must register with the state and government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to noulido@sanla ana.oro Mayor Pro Tem, Ward 2 n maninez@sanra'ana.ord fe eral unemployment compensation ol each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 2:J I understand under California Contractors' State License Law, an Owner-Builder who builds single{amily râ‚¬eC-dential structures cannot legally build them with the intent to offer them lor sale, unless a// work is performed by j!9!9!.a@$!jaj!A..a!q dbe.av'des@sanraanaoro ivilleoas@senta'anaoro sl[rai6ro@sanla.ana.oro SANTA ANA CITY COUNCIL Vrcenre Sarmienlo vsarmi6nlo(Asa.la.aaa.oro licensed subcontractors and the number ol structures does not exceeci four w,ihin any calendar years, or all of the work is pgrformed under contract with a licensed qeneral buildinq Contractor. '. -_)4. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any' finanbial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. - .'19. I understand I mav obtain more information regarding my obligations as an "employea'from the lnternal Revenue $ffirhe United States Small Business Administratio,-n, thebalifornii Department of denefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or w$ryv.cslb.ca.qov for more information about licensed contractors.4io GJGlvt I am aware of and consent to an Owner-Builder building permit applied lor in my name, and understand that I am egally an d financiall y resp onsible for propo sed constru on activity at the followi ng address:o L 6 ./)o/ "_J911. I agree that, as the party legally and f inancially responsible for this proposed construction activity, I will abide by al{ applicable laws and requirements that govern Owner-Builders as well as employers. ' ' , f2. I agree to notity the issuer of this form immediately of any additions, deletions, or changes to any of the ' inlormation I have provided on this Iorm. Licensed contractors are regulated 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 Ior verilying 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 must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note.'Aco DV oft he DroDertv wncr's driver's -se- rm the ,s uired to be ted when the issued to veri the Signature of Property Print name of Owner Own Date:2),/ <-I ?/A /Z- 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 agenl(s) to apply 1or, sign, and file the documents necessary to obtain an Owner-Builder Permil for my project. Scope ot Construction Project (or Description of Work) Prolect Location or Address Name of Authorized Aoent Address of Authorized Aqent Phone Number of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally lilled out the above information and certify its accuracy. Date Print Name of Owner Note: A copy ol the owner's driver's license, lotm notarization, or other veritication acceptable to the agency is rcquired lo be presented when the permit is issued to verily the property owner's signature. ::, r.! \.irtri -r.. r ir A. . i r'i.r.I irt,,i) r f .! i..,, :: -,rr. r - r.... -. :i- -, SANTA ANA C TY COUNCIL hoL do@sanla-ana.oro Mayor Pro Tem. Ward 2 mrmanr.ez@saf ta-a.a.oro V cenle Sarm enlo $49 j.!e!&@$ga:a!a.qq ls9lsl!@!3!la:a!a.!I!dbenav,des@sa.1a'anao.c iyiX9!as@sa&:a sl nalero@sanla-ana o.o --24 Property Owneas Signature: _