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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 I\4ANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. CaNalho <br />CLERK OF THE COUNCIL <br />l\,4aria D. Huizar <br />CITY OF SANTA ANA <br />PLANNING & BUILDINC AGENCY <br />20 Civic Center Plaza <br />P.O. Box 1988 . Santa Ana, California 92702 <br />www.santa-ana.org / 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 />improvements specified at <br />14 qht; PhnvD#Irk- |M\n+ AN+ eA A2'7oZ <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of <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 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 ACKNOWLEDGMENT AND VERIFICATION OF I N FORMATON <br />DTRECTTONS: Read and initial each statement below to signify you understand or verify this in formation <br />f\l / L 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 injuries to <br />workers on my property. <br />l,lV Z. 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 />My' g. t understand as an "Owner-Builder" I am the responsible pa(y 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 />My' q. 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 />It/ y 5. 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 federal law. <br />_Mt/ A. I understand if I am considered an "employer" under slate and Federal law, I must register with the state and <br />fbderal 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 />_LM_1. I 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 />mpulido@sanla-ana oro <br />Mrche e Maninez <br />Mayor Pro Tem, Ward 2 <br />mimani.ez@sanla-ana.oro vsa.nenlo@sanla-ana o.o irsbrle@s@b:eE 9!9 dbenavdes@san1a-ana orc ivilleoas@enta-ana.oro slina ero@sanla€na oro