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Home My WebLink About3614 W Sunswept Ave - Misc. PermitI\,4AYOR [,4iguelA. Pulido I,IAYOR PRO TEI\,1 [,4ichele Martinez COUNCILMEMBERS P. David Benavides Vicenle Sarmiento Jose Solorio SalTinalero Juan Villegas CITY OF SANTA ANA PLANNINC & BUILDING AGENCY 20 Civic Center Plaza P.O, Box i 988 . 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 improvements specified at )AA CITY MANAGEH Raul Godinez ll CITY ATTOHNEY Sonia R. Carvalho CLERK OF THE COUNCIL [raria D. Huizar Z 0 We are providing you with an OwnerBuilder Acknowledoment and Inlormation 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 OwnerBuilder. 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 oJficial 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 VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signity you understand or verify this information, V* l. I understand a frequent practice ol 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 lor 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 of my insurance coverage for injuries to workers on my property. Vll z. I understand building permils 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. lrtl S. lunderstand as an "Owner-Buildea' I am the responsible party ol record on the permit. I undersland 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 ol my own. l/t-L. I understand Conractors are required by law to be licensed and bonded in California and to |ist their license numbers on permits and conlracts. -Vt-5. t understand if I employ or otheMise engage any persons, other than Calilornia 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 "employea' under state and federal law. /lLA. I understand il 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 disability insurance, and contribute to unemployment compensation of each "employee." I also understand my lailure to abide by these laws may subject me to serious f inancial risk. Vll l. I understand under California Contractors' State License Law, an Owner-Builder who builds single{amily residential structures cannot legally build them with the intent to oller them for sale, unless a//work is performed by SANTA ANA CITY COUNCIL [o4lido@sada:ala,-Qlc [r].hel.,a lrarl nez Mayo. Pro Tem. Ward 2 mimarline2@sanla-a.a oro Vicenre Sarmrenro vsa.m enlo@sanla-ana oro soloro@sanla.ana.oro P. Davd Benavides dbenavrdes@santa.ana.o.o ivilleoas@sanla-ana.oro siinaiero@sanra'ana.oro licensed subcontractors and the number ol structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. _lAA. f understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable tor any financial or personal injuries sustained by any subsequent owne(s) that result lrom any latent construction delects in the workmanship or materials. _VLr. t understand I may oblain more information regardrng my obligations as an "employer' from the lnternal Revenue Serrice. tne United States Small Business Administration, the Callfornia Department of Benefit Payments, and the California Division ol 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 lor more information aboul licensed contractors. t /F f O. I am aware ol and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address yfl- r t. I agree that, as the party legally and financially responsible for this proposed construclion activity, I will abide by all applicable laws and requirements thal govern Owner-Builders as well as employers. t/Il lZ. I agree to notily the issuer of this form immediately of any additions, deletions, or changes to any of the information 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 obtarn a permit as Owner-Builder and wish to hire Contactors, you will be iesponsible loi verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Belore a building per mit can be issued, this torm must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. i/ore A aoDv of the rtroncrlv o wner's driver t ,i.cn-se- torm notariza . or other veritication table to the aoencv is uired to be Dresented when the Dermit is Signature of Property Print name of Owner Owner Date: 06 l,/t /\11 t-\fr AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property following person(s) to act as my project. Owner, the execution of which I understand is my personal responsibility, I hereby authorize the agent(s) to apply for, sign, and file the documents necessary obtain an Owner-Builder Permit for my Scope of Construction Project (or Descri n o{ Work) Project Location or Address Name of Authorized Agent Address of Authorized Agen Phone Number of Autho Agent ldeclare under pen ol periury that I am the I personally filled out the above information and ify its accuracy. Property Ow Signature Date Pr nt Name ol Owner: Note: A copy of the be presented when t owner's s license,ation, or other acceptable to the agency is required to he is issued to the property ture emblyaLllsrNoucâ‚¬ to Pr.ped! r.rn oJz SANTA ANA CIry COUNCIL address listed aboveperty owner for mou do@santa.ana.oro Mayor Pro Tem, Wad 2 mima.l nez@sa.la-ana o.o !$IEG!]P@SA!.8:3!3!!!isolono@santa ana.oro jvllleGs@leDla:a!@ $!eiel!@sa!E:a!34l! issued to veritv the Dropertv owner's siqnature. P Davd Benavides dbenavldes@sanla-ana oro