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Home My WebLink About3221 S Lowell St - Misc. PermitWe are providing you with an your responsibilities and poss CITY OF SANTA ANA PLANNINC & BUILDING ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana. California 92702 www.san ta-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 rmprovem .5 ents seJi oecified at'"t'tiLctt sr 3'n' 4r1ol er-Builder Ackn lnformation Verification F to make you aware of ible 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 ACKNOWLEDG MENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. W l. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildefl btrliding 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 maynot provide 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 workers on my property. Ol--2. I understand building permits are not required to be signed by property owners unless they are responsible for thb construction and are not hiring a licensed Contractor to assume this responsibility. tl-g. f understand as an "Owner-Builder" 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. fl< , understand Contractors are required by law to be licensed and bonded in California and to list their license nu'mbers on permits and contracts. _MZS f understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the totalvatue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. l}|; ,understand if I am considered an "employer" under state and Federal law, I must register with the state and fe!eral government, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. l-Yt. lunderstand under California Contractors' State License Law, an Owner-Builder who builds single-family ,"--.iO*ti"t structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by mou do@santa'ana orc Mayor P.o Tem, Wa.d 2 m ma.l nez@sanla-ana.oro vsamiento@sanla-ana oro so oro@sa.la-ana.oro dbenavdesAsanta a.a.oro ivilleoas@sa.la-ana.oro stinaiero@sa.la ana oro MAYOR MiguelA. Pulido N,IAYOR PRO TEM Michele Martinez COUNCILT,lEMBERS P David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas CIIY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carva'ho CLERK OF THE COUNCIL Maria D. Huizar SANTA ANA CITY COUNCIL licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. -&L-+ ' understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finbncial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. ,$JYS f understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, 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 information about licensed contractors. t-L;o thb party I am aware of and consent to an OwnerBuilder building permit applied for in my name, and understand that I am leqallv and finrlrl nancially responsihle for proposed -<-/1 .Yr S. r\ - construction activ ity at the following address E, 1-r'q ,-"0-l q N f f I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by dll applicable laws and requirements that govern Owner-Builders as well as employers. lEf2.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the ihformation 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 impo(ant for you to understand that lf 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 propedy 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 permit. /Vofe.' A copv of the propertv owner's driver's license, otarization or other verification table to the a ,s uired to be ted when the it is Signature of Property Owner Date /c e Print name of Owner eN1- 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. Alc ?tplau Ar '/D(os I k-'l.oirâ‚¬..i Scope of Construction Project (or Description of Work) Project Location or Address:JeAl S, (ox,l/ 9f S A. 1tto7 Name of Authorized Agent .3AAGA:1. NpLAnl Address of Authorized Agent: Phone Number of Authorized Agent:'1rul - q51 - '-{D3 I 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 certify its accuracy ? /roltgProperty Owner's Signature Date Print Name of Owner:?oBr,..l Note: A copy of the owner's diver's license, form notarization, or other veritication acceptable to the agency is required to be presented when the permit is issued to verify the propefty owner's signature. i)l irlr1t'lpll: a.!rie.A.! r !y A!3:mt,, ) 3 r.i5lr: c 1.1,r-tri/ f.- n i.:i i,1.Ua'1il SANTA ANA CITY COUNCIL MrguelA Pu do Michele Martrnez Vcenle Samenlo Jose So orio P Dav d Benavides Juan Villegas SalI najerc Mayor Mayor Pro Tem, Ward 2 Ward 1 Ward 3 Wa.d4 WErd 5 Ward 6 issued to verifu the propedv owner's siqnature. I