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MAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEM <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />SalTinajero <br />Juan Villegas <br />CITY MANAGER <br />Raul Godinez ll <br />CIIY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria O. Huizar <br />Dear Property Own <br />An application for a itdi ith s been su d in yo nam list tn elf as t buil e property <br />improvements spe ed <br />We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of <br />your responsibiliiies 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 of each provision, signed, and returned <br />this form to us at our official 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 />OWNER'S ACKNOWLEDGME NT AND VERIFICATION OF I N ORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <br />Ll I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" <br />building permit that erroneously implies that the property 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 financial 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 in,uries to <br />workers on my property. <br />-LZ I understand building permits are not required to be signed by property owners unless they are responsible for <br />the construction and are nol hiring a licensed Contractor to assume this responsibility. <br />4-g I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may <br />protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name <br />instead of my own. <br />LC I 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 />-/^ S I understand if lemployor otherwise engage anypersons, otherthan California licensed Contractors, and the <br />i6Ei value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an <br />"employer" under state and federal law. <br />LA I understand if I am considered an "employer" 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 to <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, , understand under California Contractors' 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 />Mayor Pro Tem Ward 2 <br />mimaninez1asanta-ana oro <br />V cente Sarmiento <br />warmre.lo@sanla-ana.oro isolono@sanla-a.a.oro <br />P Davd B€nsvides <br />dbenavides@sanla 6ne.oro ivill€!asaAsanl6-ana.oro stinaiero@sanla-ana,oro <br />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.orglpba <br />NOTICE TO PROPERTY OWNER <br />mpulido@santa-ana oro