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i An application for a building permit has been submitted in your name list- SAN JOAOUIN COUNTY BUILDING INSPECTION DIVISION j Ing yourself as builder of the property improvements specified. 1810 E. Hazelton Ave., Stockton, CA 95205 ff For your protection, you should be-aware that as "owner-builder" you are the REQUIREMENT OF STATE OF CALIFORNIA HEALTH 3 SAFETY CODE Sac. 19830 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 liability if that person applies for the proper permit in his dr her name.. An "owner-buiidar" building permit has been applied for In your name and Contractor's 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 arg;also 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. If you plan to do your own work, with the, exception of various trades that i�l Personally pian to provide the major labor and makes , for t you plan to suh,-contract, you should be aware of the following information onstruction. of the p oposed property improvement Yas r No} .for your benefit and protections 2. 1 have not) signed an application for a bu(i ing If you employ or otherwise engage any persons other than your immediate fam- Permit for the propose work. ily, and the work (including materials and other costs) is $200 or more for1 have,contracted with the fol wing 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. If you are an employer, you must register with the State and Federal govern- Name Phone ment as an employer aad you are subject to several obligations including. Add s State and Federal income tax withholding", Federal social security taxes, Workers' Compensation insurance, Disability insurance costs, and unemployment compensation contributions. City Contractor's License No. There may be financial risks for you if you do not carry out these obligations I plan-to provide portions of th , but I have hired the following and these risks are especially serious with respect to Workers' Compensation erson to coordinate, supery and provide the major work: Insurance . For more specific information about your obligations under Federal law"+ can- 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 of Benefit Payments and the Division of Industrial Accidents may bw contacted City Contractor's License No. If the structure is. intended for sale, property owners who are not" licensed 5. will provide some of the work but i have contracted (hired) the contractors are allowed to perform their work personally or through their own f llowing persons to provide the work indicated:- employees, Without a licensed contractor or subcontractor, only under limited conditions. Name Address Phone T e�of Work 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 am-.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,. (TJSigned , 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 Nailing Address City Sf6CfQ 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, your Workers' Compensation Insurance must be on file in this Department in the REQUIREMENT OF THE STATE OF CALIFORNIA HEALTH & SAFETY CODE, SECTION 19830 form of a, valid, current certificate from your Insurance Agent.