The URL can be used to link to this page

Home My WebLink About1121 S Golden West Ave - Misc. PermitBulldlng S.t.ty OlYblon 20 Clvlc Crrlor Phz P.O. Box l9t8 (ti-i0) S.nt Anr, CA 82702 (7la) 62a76800 wwwaanta{na.olg APP-1! CBC 2016 Oaar Proporty Orvncr An applrcrtlon for a spâ‚¬cfiod al NOTICE TO PROPERTY OWNER has bâ‚¬â‚¬n submdted in name listing yourselfas the builde, ot thâ‚¬property rmprovements We are prcvdrng you wth an to make you arare of your responsibilrties and possible risk you may incur by having this Permit issued in your names as the O'vner-8uildor. We will not lssuo s builCing permit untl you have read. initialed your understanding of each proviskln, signed, and refumed this tolm to us at our oflicral address indicated- An agent of the owner cannot execute this notice unless you, the property o!r,ner, obtain lhe pnor approval of the petmittrng aulhority. OTRECnO IS: Ro,,d ,nd lnldet oach sl,tol,rfia btow to sunlfy Wu unffind or eodfy dtk ittonnadon. -r:Ll-]1. I understand a ftequent practice of unlcensed prsons is to have the property oi/ner obtaan an 'Owner8uilde/ build- ing pâ‚¬ImIt that enoneously impliâ‚¬s that the property otvner as providing his or her own hbor and material personalty. I, as an olxnerâ‚¬uilder, may be held liabb and subject lo serious financial risk for any injuries sustained by an unlicensed person and his or her employees u,fiile working on my property. My homeowoe/s insuEmce may nol provide coverage for those injuries. I am wilfiily acting 6 an O\flnerâ‚¬uilde, and aln aware of the limits of my insurance coverage for injuries to workaYs on my prop- erty. I understand buildang pemits are not required to be signed by property owners unless they are responsible for the constucton and are mt hiring a licansed Contractor to assume this responsibility. _lt[L3. I undeEtand as an 'Ownerâ‚¬urHel. I am the rcponsible party of lecod on the pâ‚¬rmrl I undersland lhat I may proted miEelt trom potential financial .i3k by hiring a licensed Contractor and having tho pormit fled in his or her namâ‚¬ inslead ol my -!fl.1. t urterscna Contrado6 are requircd by bv to be licensâ‚¬d and bonded in Califomia and b list their license numbeB ofl p6rmil6 and cont'acts. jL\125. I understand if I employ or othâ‚¬rwiso engage any persoas, other than Califomia licansed Contractors, and the total value of my consfuclion is at lsast fiv6 hundred dollars ($500). including labor and matedals, I may be considâ‚¬red an 'empbye!' under Etato ard ,â‚¬dd-al bw- fi/6. I undorstand ll I am con$dâ‚¬Ed an "employq' under state and Federal law, I must.egaster with the staE and federal Cdfommâ‚¬nt wthhold payroll taxes. provire u/oakers compensation disability insurance, and contribute to unemployment com- pgn6ation of eadr 'emdoyeo.' I also urdoratand my failure to abide by thesâ‚¬ laws may gubjecl ma b serious fnancial risk. -2d-f7. I undâ‚¬r6bnd under Calforn6 Contractors' S-tate Lbensâ‚¬ Law. an Owner-Builder who builds single-family residenlial 6tndlurss cannol lsgaly build them with thg inbnt to offer them lor 6ale, unless a/ work is perrormed by licensed $ibconkac- tofs and thâ‚¬ number of sfucfuIes does not exceed foua within any calendar yeaas, or all of the work is perfoamed under contaact with a lEerEed general bu drE Conhaclo.. /1^ lh/g t unaer*ana as an Ownerâ‚¬uiuer if I sall fio propâ‚¬.ty for which thB permat is issued, I may bâ‚¬ held liable ior any finaft dal or personal rnlunes sustaingd by any Bubsâ‚¬quent owne(s) lhat re6ult trom any latenl const ucton defects in the workman- ship or matorials. irlrr Ufo Sfr slni *,rftc.g ^d,ilriltdorr fro c*o;ar t*r..tlr rt oc e.r*l A,rn"rlB, rnd $â‚¬ Calbrnia Divitill o,lndlEtd Acclant3 l*o t rxlcrt.d I rEy cotlad tE CCilUda CqtfaEbr'Srb tirt'e Bo6d (CSl,l) at r.8(xr- 32r aSLB (2752) a t&.fhg.g!! h. mo.! i oona..n Sota br.â‚¬d qltsacbt. fl!-f O. t an mrc ot rd cql.s{ b a.t oti,rtâ‚¬ â‚¬older tuiHirig pfidt applâ‚¬d br h my nrno. ar|d urd rbrd tlat I an tlcptf, bo.ly and lha,|(iay ,rrponlab lb. Foposâ‚¬d drstudiro adn fy at thG ,ofqyrng a4 JkNl r . t aoreG olat a thâ‚¬ party lâ‚¬gafy and finaftially râ‚¬6porrrbb lor thr! p.!pos6d co.E8rr.lbo aclrr/ty. I ra abiro b, d app6c.trb bt^,3 arld requirenronts tiat govem Osne.Suiusrs as Bei as ompbyers. .ftC f Z. f "gr* O *ffy th6 issuâ‚¬. ot this bm irirnedralâ‚¬ly ol ary addilirns, doblirrs o. chsngâ‚¬s b a'ly ot lho in'orr|ratioi I have Foviled on this bm, Li:e'lsâ‚¬d coot-aclors ar! ,ggdated by lariu desiJned to prote.i tno public. lf you co.llr&t wifi Gomoonâ‚¬ wtro does not hay. . l-ensâ‚¬. the Con!_adorE' Stale Li:ens6 Boatd nEy be unabb to assisl you wih any finaflcial bsg yoo may 6u6t8h as a reau[ of a cofiplaint Your only tertcdy against uhltcensed Contiaclors may bâ‚¬ in civil oourt lt ls aho irnpo.tant tor you io urderEtard 0!at if an unli:ensâ‚¬d Cmtrador or arnploysâ‚¬ of that individual or firm b iniured while working on your Foperty, you may be hGld liaug b. dfirages. l, Fu oblain a pGtrnit as Oyvne.â‚¬uilder and *ish to hire Conbdols, you rrill be ,aspo.libb fo. vedfying whctle or nol those Coflfadors are property licansed and the smls of their t rorters' coripensaton insuEhoe coverags. Signan re ot ttoperty otnnâ‚¬f,Oate ,E Par name o, Ouner k}t;l,zevJ )4o AUTHOR|ZATIOTI OF AGE}|T TO ACT ON PROPERTY OUTNER'S BEHALF Erduding the Noltce to Property Owner, the execllIidr ot which t understard is my personal rcsponsibility, I heeby authonze tE foIowing perso.t{s) b ac{ 63 riry agent(6) to apply tor, s(ln, and 6le the docuoents necessary b obtain an Ornerâ‚¬uilder Permt b. my projer:t Scope ot C,onsurrclbo P,qâ‚¬art (oa Oescriplirn o, Prqâ‚¬d Locatirn or ArHag$:ilL G,O (ft t 1 Naftâ‚¬ ot Artho.iz:ed A96nt l^tl, i,D Addrâ‚¬s6 o, AuttrdEed )c "iz6 z-n Phonâ‚¬ Numbe, ot ArtrE iz6d A0oot q Ziz- g I dâ‚¬c.lare under peflaty of pâ‚¬qrr.y lhal I arn the propeny osner to. ihe addre6s tsted above and I persoidty f[ed olt lhe above info.matbn a , cerlity i5 acorracy Propqly Orne/5 Sâ‚¬nature 2z-"2.:2; PrElt Nantâ‚¬ ol OYUtlâ‚¬t: No,.: A cqy ot th. arrr.t . dy.l, ticaa,lotu tl,''r,k,.don, or oah.r vadlcaloo accq,,,U. to thr lgcocy tr ar-qulrd b b lrt,r,ntd urraD th. p@mlt l, lsru.d ao v.ttty rhe yopcrty own.ft .lg/,trlrn,rt, ,9otei t topettv owner's slona,ure. ,)