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i An application for a building permit has been submitted in your name list- SAN JOAQUIN COUNTY BUILDING INSPECTION DIVISION ing yourself as builder of the property improvements spec.ifi,ed. 1.810 E. Hazelton Ave., Stockton, CA 95205 For your protection, you should be aware that as "owner-builder" you are the _REQUIREMENT OF STATE- OF CALIFORNIA HEALTH & SAFETY CODE, Sec. 19930 responsible party of record on such a permit. Building permits are not re- quired to be signed.by property owners unless they are personally performing OWNER-BUILDER VERIFICATION, their own work. If your work is being performed. by someone other than your- Attention Property Owner: self, you may protect yourself from possible liabi.lity. if.that person applies. for the 'proper permit in his or her name. An "owner-builder" building permit has been applied for in your name and Contractors are required by law to be licensed and bonded by the State of , bearing your signature. Please complete and return this information to California, and may be required to have a business license from.the city or avoid unnecessary delay in processing and issuing your building permit. county..- They are: a.lso required by law to put their license number on all No building permit will be issued until this verification is received. permits for which they apply. 1. I personally plan to provide the major labor and materials for the if you.plan to do your own work, with the exception of various trades that construction. of the proposed property improvement (Yes or No) r you plan to sub-contract, you should be aware of the following information y for your benefit and protection: 2. 1 (have/have not) signed an application for a building if you employ or otherwise engage any persons other than your immediate fam- permit for the proposed work. ily, and the work (including materials and other costs) is $200 or more for 3. 1 have contracted with the following person (firm) to provide the . -the entire project, and such persons are not licensed as contractors or sub- proposed construction: contractors; then you may be:an employer. b u Phone If you are an employer, you'must register with the State and Federal govern- -. Name ment as an employer and you are subject to several obligations including Address State and Federal income tax withholding, Federal social security taxes, Workers' Compensation insurance, Disability insurance costs, and unemployment City Contractor's License No. compensation contributions. There may be financial risks for you if you do not carry out these obligation4. 1 plan- to provide portions of the work, but I have hired the following s and these risks are especially serious with respect to Workers' Compensation person to coordinate, supervise and provide the major work: Insurance For more specific information about your obligations under Federal-law, con- Name Phone tact the Internal Revenue Service (and, if you wish, the U.S. Small Business Address Administration). For more specific information about your obligations under State law, the Department off Benefit Payments and the Division of Industrial City Contractor's License No. Accidents may be contacted If the structure is intended for sale,': property owners who are not-licensed 5. 1 will provide some of the work but I have contracted (hired) the contractors are allowed to.perform their work personally or through their own following persons to provide the work indicated: employees, Without.a licensed,contractor or subcontractor, only under limited conditions. r A- Name Address. Phone Type Work r f A frequent practice of unlicensed persons professing to be contractors is to secure an "owner-builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building Permits are not required,to be signed by.property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State.License Board at 1020 "N" Street, Sacramento, CA 95814. The State of California Health and Safety Code, Section 19830, Chapter 9, - Signed , Property Owner Part. 3, division 13, requires us to make you aware of these laws and ordi- nances, and requires you to complete the form on the right and return it to Mailing Address City us before we. may issue your permit. Any contractor you list must have his State Contractors License number on Location of Building to be Done file in this Department, and'a current, valid Certificate of Workers' Com- pensation Insurance (or waiver) also on file in this Department Social Security Number Date If you are- hiring someone other than a contractor to do the work, youru Workers' Compensation Insurance must be on file in this Department in the REQUIREMENT OF THE STATE OF CALIFORNIA HEALTH & SAFETY CODE, SECTION 1#830 9 form of a valid, current certificate.from your Insurance Agent. kL