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Home My WebLink About911 N Olive St - Misc. PermitIVAYOR Miguel A. Pulido MAYOR PRO TEI\,,I Michele l\.4artinez COUNCILIVEI\,IBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Viliegas CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I 988 . Santa Ana, California 92702 www.santa-ana.orglpba 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 WeareproVidingyoUwithantomakeyoUawareof your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. OWNEB'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this intormation. (D . I undersland a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" buildinq 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 linancial 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. l-------2. I understand building permits are not required to be signed by propeny owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 1,,' 3. I understand as an "Owner-Builder" Iam the responsible party ol record on the permit. Iunderstand that Imay [roFa myself from potential tinancial risk by hiring a licensed Contacor and having the permit filed in his or her name instead of my own. L=. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand il I employ or otherwise engage any persons, other than Calirornia 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 federal law. i4 | understand if I am considered an "employei' under slate 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 ol each "employee." I also undersland my failure to abide by these laws may subject me to serious financial risk. 4. ,understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to oller them for sale, unless a// work is perFormed by SANTA ANA CITY COUNCIL vsarmrenlo@santa ana.o.o isolor o@santa.ana.oro dbenavLdesrasanla.ana.oro CITY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLEBK OF THE COUNCIL N4aria D. Huizar 0-cdr!9@sada:a!e.qq Mayor Pro rem, Ward 2 m madrnez@santa'an6.oro iv lr6.as@sania-ana.orc sInaiero@sanla-ana.oro 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. licensed subcontraclors and the number of structures does not exceed four within any calendar years, or all ol the work is - performed under contract with a licensed general building Contractor. -O-U. , understand as an Owner-Builder i, I sell the property for which this permit is issued, I may be held liable Ior any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. C--g I understand I may obtain more information regarding my obligations as an "employer" Irom the Internal Bevenue Service, the Uniied States Small Business Administration, the California Department of Benelit Payments, and the Calilornia 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 f or more information about licensed contraclors. Da: -fi. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible lor proposed construction activity at the following address /1La_]t1.1 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. ClZ.I agree to notily the issuer ol this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Llcensed 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 impoftant for you to understand that if an unlicensed Contractor or employee ol that lndividual 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 verlfying 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 form must be completed and signed by the property owner and returned lo the agency responsible for issuing the permit. Note.' A copv ot the propertv ownet's driver's license. torm notarization. or other veritication acceDtable to the aoencv is required to be sented when the Dermit is owner's Signature of Property Owner Date g Print name of Owner 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 lile the documents necessary to obtain an Owner-Builder Permil lor my U Scope of Construction Project (or Description of Work):- Prolecl Location or Address Address of Authorized Agenl Phone Number of Authorized Agent ldeclare under penalty ol perjury that I am the property owner lor the address listed above and I personally filled out the above information and certily its accuracy.Date:_ Prinl Name ol Owner Note: A, copy ol the owner's driver's license, form notarization, or other veritication acceptable to the agency is required to be presented when the permit is issued to verity the prcperty owner's signature. SANTA ANA CITY COUNCIL moul do@sa.ra-ana oro Mayor Pro Tem, Ward 2 !oEa!I!e?@!aqa:a!@ isoloro@sanla.ana.oro P. Oavid Benav des dbenalrles@sarla:ara.a4 snnaEro@santa ana.orovsarm e.ro@sanla ana oro vr lcoas@santa ana.o/o Name ol Authorized Agent: Property Owneas Signature: