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Home My WebLink About1636 W Wisteria Pl - Misc. PermitMAYOR t,4iguel A. Pulido MAYOR PRO TEt\,1 Michele Martinez COUNCILMEMBERS P. Oavid Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, Californiag2T02 www.santa-ana.org/ pba NOTICE TO PROPERTY OWNER Dear Property Owner: An application lor a buildlng permit has been submitted in your name listing yourself as the builder of the property improvements specilied at I b c 5"^+.q We are providing you with an OwnerBuilder Acknowledoment and lnformation Verification Form to make you aware ol your responsibilities and possible rlsk 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 ol each provision, signed, and returned this form to us at our oflicial address indicated. An agent ol the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFI CATION OF INFORMATON DIBECTIONS: Read and initial each statement below to signify you understand or verify this information. ll= t. I undersland 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 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 for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits ol my insurance coverage lor injuries to workers on my property. Er. I understand building permits are not required to be signed by property owners unless they are responsible lor the construction and are not hiring a licensed Contractor lo assume this responsibility. Es. I understand as an "Owner-Buildei' I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. lE q. t understand Contractors are required by lawto be licensed and bonded in California andto listtheir license numbers on permits and contracts. I C5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and lederal law. T4. , understand il I am considered an "employei' 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 of each "employee." I also understand my failure to abide by these laws may subject me to serious Iinancial risk. ' I 14 I . I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to offer them lor sale, unless a//work is performed by SANTA ANA CIIY COUNCIL CITY [,4ANAGER RauLGodinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL [.4aria D. Huizar P Dav,d Benavrdes dbenav des@sanla-ana.o.omoulido@sa.la.ana.o.o Mayor Pro Tem, Ward 2 m ma.line2@sanla-ana.oro Vcenre Sarmienlo vsarm e.to@sanla ana.oro isolorio@senla.ana oro iv lleoas@enla-ana.oro slr.aiero@sanla ana.oro 1 licensed subcontractors and the number ol structures does not exceed lour within any calendar years, or all of the work is performed under contract with a licensed general building Contractor.'Tr I L8. I understand as an Owner-Builder il I sell the property for which this permit is issued, I may be held liable for any frn-ancral or personal injuries sustained by any subsequent owne(s) that result from any latent construction delects in the workmanship or materials. I understand I may obtain more information regarding my obligations as an "employea'from the lnternal Revenue Service, the United States Small Business Administration, the California Department ol 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. IBo the party address: lam leoall-lL aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am v and linancia nsible I or orooosed conS";L ,("-struction activl ty at the following < c v.\1 C*q r7o3 TEt.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. -fu12. lagree to notify the issuer o{ this form immediately of any addilions, deletions, or changes to any of the inlormation 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 Ioss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also impodant for you to understand that if an unlicensed Contractor or employee of that lndividual or firm is injured while working on your property, you may be held liable for damages. ll 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 lorm must be completed and signed by the property owner and returnedtotheagencyresponsibleforissuingthepermit.Note: form notarization, or other verification acceDtable to the aoencv is reouired to be ted when the Dermit is owner's si nature. Signature ol Property Owner Date S l0 Print name of Owner ", EL""4 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 project. Scope ol Conslruction Project (or Description of Work) Project Location or Address Name of Authorized Aoent Address of Authorized Agenl Phone Number oi Authorized Agent I declare under penalty ot 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 Owner's S gnature Date Print Name of Owner Note: A copy ot the owner's driver's license,lorm notarization, or other veriflcation acceptable to the agency is required lo be presented when the permit is issued to verily the property owner's signature. ) r v,i ii,.r... i,.,. . t i.i.r!. irirri. :.r:.r_ rl lii!.-t! t r :. a:' 1.1 llli SANTA ANA CITY COUNCIL mouirdo@santa-ana oro Mayor Pro Tem, Wad 2 4m!nl!ez@!a!la:a!@ Vrcente Sarmlenro vsa,m ento@sanra'ana oro isolorio@sanla-a.a.oro dbenav dcs@sanla 3.a oro tilleoas@santa.ana.oro sl naiero@sanla-ana.o.o ly I