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3a t fiorut <br />MAYOR <br />llliguelA. Pulido <br />I,{AYOR PRO TEM <br />l\,4ichele Martinez <br />COUNCILME[,4BERS <br />P. Oavid Benavides <br />Vicente Sarmienlo <br />Jose Solorio <br />SalTinajero <br />Juan Vallegas CITY OF SANTA ANA <br />PLANNING & BUILDING ACENCY <br />20 Civic Center Plaza <br />P,O, Box 1988 . Santa Ana, California 92702 <br />www,santa-ana,or9 / pba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application for a building permit has been submitted ln your name listing yourself as the builder of the property <br />improvements specified ut <br />t ) 41 \Z\S+ SO A Qrro ( <br />We are providing you with an OwnerBuilder Acknowledoment and lnformation Verification Form to make you aware ol <br />your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. <br />We will not issue a building permit until you have read, initialed your understanding ol each provision, signed, and returned <br />this lorm to us at our olficial address indicated. An agent of the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval of the permitting authority. <br />OWNEB'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand ot verity this information, <br />8q 1. I understand a frequent practice o, unlicensed persons is to have the property owner obtain an "OwnerBuilder" <br />building permit that erroneously implies that the propeny owner is providing his or her own labor and material personally. l, <br />as an Owner-Builder, may be held liable and subject to serious linancial risk for any injuries sustained by an unlicensed <br />person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for <br />those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to <br />workers on my property. <br />0..2. I understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are not hiring a licensed Contractor to assume this responsibility <br />3. I understand as an "Owner-Buildei' I am the responsible party of record on the permit. I understand that I may <br />protect myself from potential linancial risk by hiring a licensed Contractor and having the permit filed in hls or her name <br />instead ol my own. <br />b1t o. ,understand Contractors are required by law to be licensed and bonded in California and to list their license <br />numbers on permits and contracts. <br />bLs. I understand if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the <br />total value of my construction is at least live hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and lederal law. <br />BA-U. , understand if I am considered an "employei' under state and Federal law, I must register with the state and <br />federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute lo <br />unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk. <br />l\',\ 7. I understand under Calilornia Contraclors' State License Law, an Owner-Builder who builds single-family <br />residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />CITY MANAGER <br />RaulGodinez ll <br />CITY ATTORNEY <br />Sonia Fl. Carvalho <br />CLERK OF THE COUNCIL <br />lvlaria D. Huizar <br />mouldo@santa ana.oro <br />[,!ayor Pro Tem, Ward 2 <br />m merl nez@santa ana oro <br />vicente Sarmienro <br />vsarmlenlo@sanla ana.oro <br />P Oavid B6navrd6s <br />dbenavrdes@sanra'ana oro ivrlleoas@sanla'ana o.o stinaiero(osanta'ana oro <br />, <br />isolorio@sanra.e.a oro