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MAYOR <br />MiguelA. Pulido <br />MAYOR PRO TEI\,4 <br />Michele Martinez <br />COUNCIL[,4EIUBERS <br />P. Oavid Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />Sal Tinajero <br />Juan Villegas <br />CITY MANAGEB <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />lvlaria D. Huizar <br />CITY OF SANTA ANA <br />PLANNINC & BUILDING AGENCY <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 in your name listing yourself as the builder of the property <br />improvementsspecified"t l)cg g,p"rL L^ so^l . an,., 6s, c0')o5 <br />moU do@sanla.ana.oro <br />Mayor Pro Tem, Ward 2 <br />mrmanroez@sanla.ana.o.o isolono@sanla.ana.or. <br />P Oavid B€.avides <br />dbenavides@santa.ana.oro ivilleoas@sanla'ana.oro <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware ol <br />your responsibilities and possible risk you may incur by having this permit issued ln 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 oflicial 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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you underctand verity this information. <br />Jl]<-1. I understand a f requent 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. lVly homeownels 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 />-XJ4 2. I understand building permits are not required to be signed by property owners unless they are responsible lor <br />the construction and are not hiring a licensed Contractor to assume this responsibility. <br />d(d' ,. I understand as an "Owner-Buildei' I am the responsible party ol 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 liled in his or her name <br />instead of my own. <br />J\().l<' 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license <br />nurnbers on permits and contracts. <br />f,'4L t. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the <br />total 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 lederal law. <br />-/1Jl^tt 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and <br />federal gorernment, 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 Iinancial risk. <br />VJ/" z. I understand under California Contraclors' State License Law, an OwnerBuilder who builds single-lamily <br />residential structures cannot legally build them with the intent to oller them for sale, unless a//work is performed by <br />SANTA ANA CITY COUNCIL <br />vsarm ento@sanla.ana.o.o sl naiero@santa'ara.oro