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HomeMy WebLinkAbout2210 N Laird St - Misc. PermitMAYOR Migue A. Pu ido IVAYOR PRO TEIV l\richele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDING AGENCY 2o Civic Center Plaza P.O. Box 1988 . Santa Ana. California 92702 www.santa-ana.org / pba NOTICE TO PROPERTY OWNER Dear Property Owner: rmp rq ements s ecified at N NJA J 0.6D We are providing you with an Owner-Builder Acknowledoment and lnformation Verification 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 ot the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIBECTIONS: Read and initial each statement below to signity you understand or verity this information. 9ttr. r understand a lrequent practlce of unlicensed persons is to have the property 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 Owner-Builder, may be held liable and subject to serious flnancial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. lvly homeowner's insurance may not provide coverage lor those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 'Lz. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. L( , , understand as an "OwnerBuildea' I am the responsible party of record on the permit. I understand that I may protect myself from potential linancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead ol my own. q 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. qft S. lunderstand il I employ or otherwise engage any persons, other than California licensed Contractors, and the total value ol my construction ls at least live hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. r t-L\ fl 6. I 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 disabllity insurance, and contribute to unemployment compensaiion of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. r-w reside moulido@sanra.ana.oro Mayor Pro Tem, Ward 2 m martinez@saola-ana.oro 7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily ntial structures cannot legally build them with the intent to oller them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL vsarmenlo@sanlaana.oro lsolorlo@sa.ta-ana.oro P David Eenavrdes dbenav des@sanla-ana.oro i!ile9rs@!ada:a!@ sli.aiero@sanla a.aoro An application for a building permit has been submitted in your name listing yourself as the builder of the property CIIY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Caf"alho CLERK OF THE COUNCIL [,4aria D. Huizar licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under conlract with a licensed general building Contractor. Vf A. t understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. i'..-}ll 9. I understand I may obtain more inlormation regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Admrnistration, 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 (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more inlormation about licensed contractors. _41i-t O. I am aware of and consent to an Owner-Builder building permrt applied for in my name, and understand that I am the party legally and financrally responsible for proposed construction activity at the Iollowing address: SFI f f. I agree that, as the party legally and {inancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. ]LLLf Z. f agree to notif y the issuer of this form immediately ol any additions, deletions, or changes to any ol the irito/mation I have provided on this lorm. 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 il an unlicensed Contractor or employee ol that individual or firm is in]ured 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 verilying 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 torm must be completed and signed by the property owner and returned to the agency responsible lor issuing the permit. Note.'A coDv ot the propertv wner's driver's license. form notarization. or other tion acceDtable to the aoencv is reouired to be Dresented when the Dermit is Signature of Property Owner Date:ft.t I 49 Print name ol Owner CA i.tr.-l r 0+\F AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution ol 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-Buiider Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address Name of Authorized Agent Address of Authorized Agent Phone Number of Authorized Agent I declare under penalty ol periury that I am the property owner lor the address listed above and I personally filled out the above intormation and certily its accuracy. Property Owner's Signature Date Print Name of Owner Note: A copy ol the owner's driver's license, tom notarization, or other veritication acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. SANTA ANA CITY COUNCIL moulido@sanla-ana or. Mayor Pro Tem. Ward 2 mmar! nez@sa.ra ana.oro vrcenre Sarmienlo vsarmrenlo@sanla.ana oro isglo!io@a4!:@a4q dbenavdes@sanlaana.oro iytJeC!S@!39!:a!3 strnaero@sanla.a.a oro issued to verifv the Drooertv owner's sionature.