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Planning & Building Agency <br />Building Safety Division <br />20 Civic center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />APP-13 CBC 2016 <br />NOTICE TO PROPERW OWNER <br />An applicati <br />specified at <br />on for a building permit has been-submitted in your name listing yourself as the builder of the property improvements <br />B\-t N L E,vt(t-- 9-r. <br />We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this <br />form to us at our official address indicated. An agent of the owner cannol execute this notice unless you, the property owner, <br />obtain the prior approval of the permitting authority. <br />OWNER'S ACKNOWLEGM ENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signify you understand or veify this information. <br />lx I . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildef' build- <br />ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an <br />Owner-Builder, may be held liable and subject to serious flnancial risk for any injuries sustained by an unlicensed person and <br />his or her employees while working on my property. My homeowner's insurance may not provide coverage for those iniuries. I <br />am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- <br />er9y'A:2. I understand building permits are not required to be signed by property owners unless they are responsible for the <br />construction and are not hiring a licensed Contractor to assume this responsibility. <br />" 4c S. I understand as an "Owner-Buildef' I am the responsible party of record on the permit. I understand that I may protect <br />myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my <br />own. <br />&_q I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers <br />on permits and contracts. <br />4 S. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total <br />{alu-e 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 />-L A t understand if I am considered an -employer" under state and Federal law, I must register with the state and federal <br />government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- <br />pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.A' 7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential <br />!i I-tures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontrac- <br />tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract <br />with a licensed general building Contractor. <br />ffi I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- <br />cial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman- <br />ship or materials. <br />Dear Property Owner: <br />We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of your <br />responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder.