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Home My WebLink About717 S Garnsey St - Misc. Permit[TAYOR Miguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDING ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.or9 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 specif ied at\./ /t arla E a</ro l\--) S 6flmS<,0+- S} WeareproVidingyouwithantomakeyoUawareoI 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 underslanding of each provision, signed, and returned this form to us at our o{ficial address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNEH'S ACKNOWLEDGMENT AND VERIFICATION OF INFOBMATON DIBECTIONS: Bead and initial each statement below to signify you understand or verify this information. A?( l. t understand a frequent practice ol unlicensed persons is to havethe propedy owner obtain an "OwnerBuilder,' building permit thal erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, 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 of my insurance coverage for injuries to workers on my property. ,nL 2. I understand building permits are not required to be signed by property owners unless they are responsible for th'e construction and are not hiring a licensed Contractor to assume this responsibility. ,14 L 3. I understand as an "Owner-Buildea' I am the responsible party ol record on the permit. I understand that I may piotect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ,141 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license nr"imbers on permits and contracts. t? a 5. I understand il I employ or otherwise engage any persons, other than California licensed Contractors, and the tdtal value ot my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employea' under state and federal law. k4 ( 6. I understand if I am considered an "employei'under state and Federal law, I must register with the state and feileral 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. ,4( 7. I understand underCalifornia Conlractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent 1o offer them lor sale, unless a// work is performed by SANTA ANA CITY COUNCIL CITY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF IHE COUNCIL [,4aria D. Hui2ar Eprud!@sada:ala.llq r,,layor Pro Tem Wa.d 2 mmannez@sanra-ana.oro Vicente Sarmiento vsa.mienlo@sanla-a.a oro isoloro@sanla.ana.oro P David Bâ‚¬navdes dbenavrdes@sanla.ana.oro ivirieoas@sanra ana oro srnaiero@santa ana oro 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. yn L 8. I 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. _9. I understand I may obtain more information regarding my obligations as an "employer" f rom the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benelit Payments, and the ' California Divlsion of lndustrial Accidents. I also understand I may contact the Cali{ornia Contractors' Stale License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov Ior more information about licensed contractors. 77't ( lO.l am aware ol and consent to an Owner-Builder building permit applied for in my name, and understand that I am the partylegBlly and {inancially responsible for proposed construction activity at the following q4( 11.1 agree that, as the party legally and Iinancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. l4Zlz.l 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 lirm 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. Belore a building permit can be issued, this form must be completed and signed by the property owner and returned lo the agency responsible for issuing the permit. Nore.' A copv of the propertv owner's driver's license. form notarization. ot other verilication acceDtable to t aqencv is required to be presented when the Dermit is issued to verifv the owner's siqnature. Signature o{ Properly Owner Print name of Owner g Date ,P t,lorr'a â‚¬ CqslrO 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 lollowing person(s) to acl as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope oi Construction Project (or Description of Work) Project Location or Address Name ot Authorized Agent Address of Authorized Agent Phone Number of Authorized Agent I declare under penally of perjury that I am the property owner for the address listed above and I personally filled out the above inlormation and cerlify its accuracy. Property Owneas Signature Date Print Name of Owner Note: A copy of the owner's driver's license,lorm notarization, or other verilication acceptable to the agency is required to be presented when the permit is issued to verify the ptoperty owner's signature. SANTA ANA C'TY COU\CIL mo!Ildo@santa.ana.oro Mayor Pro Tem. Ward 2 m man nez@sanla ana oro Vicente Sarmienro vsarm'ento@sa.la ana.oro isolor o@sanla ana oro P. Davd Benavides Juan villegas SalT,najero Ward { Ward 5 Ward 6 dbenavdes@sanra-a.aoro ivill6das@sanra-ana.oro stnaie.o@sanra'ana.oro