The URL can be used to link to this page

Home My WebLink About1440 S Broadway - Misc. Permit (2)MAYOR MiguelA. Pulido MAYOR PRO TEM Michele lvlartinez COUNCIL|\,llEMBERS P. David Benavides Viceflte Sarmiento Jose Solorio Sal Tinajero Juan Vlllegas CIIY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL t\,4aria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.org/pba 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 tm ents s fied a ?toOUa, We are providing you with an to make you aware of your responsibilities and possibl e 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 permitting authority. OWNER'S ACKNOWLEDGMENT AND VE RIFICATION OF INFORMATON DIREC S: Read and initial each statement below to signify you understand or verify this information. I understand a frequent p ractice of unlicensed persons is to have the property owner obtain an "Owner-Builder" it that erroneously im plies that the property owner is providing his or her own labor and material personally. l, asanO wner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by a n unlicensed person and his or her emptoyees while working on my property. My homeowner's insurance may not provi de 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 rkers on m y property 2. I understand building permits are not required to be signed by property owners unless they are responsi ble for nstruction and are not hirin g a licensed Contractor to assume this responsibility ect m l understand as an "Owner-Builder" l am the responsible party of record on the permit. I understand that I may yself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of m y own 4 I understand Contractors are required by law to be licensed and bonded in California and to list their license on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the e of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an b lvalu r" under state and federal law 6. Iunderstand ifIam considered an "employer" under state and Federal law, I must register wit h the state and era lgo vernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unempl oyment comp financial risk. ensation of each "employee." I also understand my failure to abide by these laws may subject me to S 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family ential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL mpulido@sanla-ana oro Mayor Pro Tem, Ward 2 mimarlrnez@santa-zna.oro Vicenle Sarmienro vssrmlento@santa-ana.oro iso oriolosanla-ana.oro P Davd Bâ‚¬navides dbenavrdes@sanla-ana oro iv leoas@santa-ana oro stinaiero@sanlaâ‚¬na.oro licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is p erformed under contract with a licensed general build ing Contractor L l understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any n n cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the wor nship or materials 9. lunderstand lma y obtain more information regarding my obligations as an "employer" from the lnternal Revenue lce,the United States Small Business Adminastration, 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 (CS at 1 -800-321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am party legally and financially respo nsible for prop sed construction activity at the following 7 ?A7oladdress 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by applicable laws and requirements that govern Owner-Builders as well as employers nform 2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the ation I have provided on this form. 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 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 mit. Note.' 4 of ti form notarization or other verification when the it is issued to Signature of Property Owner Date Q> Print name of Owner W u <- 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. Name of Authorized Aqent Address of Authorized Agent 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 filled out the above information and certily its accuracy. Date Print Name of Owner: Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. lrr .[ ri]Pa i .r |irr i\:r! rr'i::r,.: r11 .rii)r,{it,p..t.\:t..-,...,1.\a.a SANTA ANA CITY COUNCIL solo.o@sant6 ana oro P Oavid Benavdes dbenavrdes@sanla-.na.o.o ivilleoas6sanlaâ‚¬.a o.o sl'na e106sa.ta a.a oro ScopeofconStructionProject(orDescriptionofWork): Project Location or Address: Prope(y Owner's Signature: MrguolA Puido Mlchere Manrnez Vrcenre Sa.rnienloMayor Mayor Pro Tem, Ward 2 Ward 1 mou do@santa an6 oro m harlinez@sanla-ana oro vsarmrenio@sanla-ana.oro