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MAYOB <br />Miguel A. Pulido <br />MAYOR PRO TEM <br />N.4ichele l\rartinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmienlo <br />Jose Solorio <br />SalTinajero <br />Juan Villegas CITY OF SANTA ANA <br />PTANNING & BUILDING ACENCY <br />20 Civi. Center Pla2a <br />P.O. Box I 988 . Santa Ana, california 92702 <br />www.santa-ana.orglpba <br />NOTICE TO PROPERTY OWNER <br />Dear Property Owner: <br />An application for a building permit has been submitted in your name listing yoursell as the builder ol the property <br />'^o'ryf4"^t*"/il:fl7L sa Sa,h fr,.^-. ch lt)oq <br />We are providing you with an Owner-Builder Acknowledoment and ln{ormalion 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 ol each provision, signed, and returned <br />this lorm to us at our ollicial address indicated. An agent of the owner cannot execute this notice unless you, the property <br />owner, obtain the prior approval ol the permitting authority. <br />OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON <br />DIRECTIONS: Read and initial each statement below to signity you understand or verify this information. <br />L^/ 1. I understand a lrequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel' <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. Ivly homeownels insurance may not provide coverage for <br />those in.iuries. I am willlully acting as an Owner-Builder and am aware of the limits of my insurance coverage lor injuries to <br />workers on my property. <br />-LltJZ. 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 Iicensed Contractor to assume this responsibility. <br />tF-l S. I understand as an "Owner-Buildel' l am the responsible party of record on the permit. lunderstand that I may <br />protect myself from potential financial risk by hiring a licensed Coniracior and having the permit filed in his or her name <br />instead ol my own. <br />Li-/ 4. I understand Contractors are required by lawto be licensad and bonded in California and to listtheir license <br />numbers on permits and contracts. <br />L-t'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 />Ut A. I undersland il 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 to <br />unemployment compensation ot each "employee." I also understand my failure to abide by these laws may subject me to <br />serious financial risk. <br />L^.J 7 . I understand under California Contractors' State License Law, an Owner-Builder who builds single-family <br />resiOentiat structures cannot legally build them with the intent to offer them lor sale, unless a//work is peiormed by <br />SANTA ANA CITY COUNCIL <br />CITY IVANAGER <br />Raul Godinez ll <br />CITY ATTORNEY <br />Sonia R. Carualho <br />CLERK OF THE COUNCIL <br />Maria D- Huizar <br />qs!r!c@ra!-la:eB"e!c <br />Mayor Pro Tem, Ward 2 <br />rn nanrne2@santa-ana oro <br />Vicente Sarmlenlo <br />rts!8i9!l!@ti!l4e!n9l!isolorio@sa.ta-ana oro <br />P Davrd Be.avdes <br />dbenav des@sanla-ana.o.o lsle!3s@s3da:a!a4!q sllnaiero@sa.laana.oro