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DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21660 E Coplcy Drive Suiie 190 '
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=-�---�'/� F ` 21560�•EAST COPI,EY bRIVE.SIIITE 190 . • •
.''.�`-;:l t ` � �, ' 1 � ' .DIAMOND BAR, CA 91765-q7.77
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��, 909-860-3195.FAX 909-861-3117
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r9 gg� . Job�Ad dr e s s: �.,,� 7,�. ,•�o ,� 1 `C.�. c,..
�ear, Property owner: . • , � ' '
An application 'for a building permit has been submittEd in your name '
�tati�ng yourself ,as the builder of the property improvenents specified. . , f •
� For your protection; you �should be aware that as "owner-bui.lder" you are
:he. responsible party of xecord.•on �such a permit. .Building permits are �ot .
:equired to be signed by proper�y owners unless they are personally � ,
�erforming their own work. If your work- is beinq performed by someone other
�han yourself, you may protect yourself from possible liability if that
�erson• applies f or the proper•permit in his or her name.
� ••Contractors are .required by la�a to. be licensed and bonded by the State
�f California and to have a business license fron the City or Coun�y. They
are also required by law to put their license number on all permits �or which
they apply. •
-- �,Z f you employ or otherwi.se engar,e any persons other thar► your immediate
family, and the wor}: �(inclui3ing materials and other costs) is $200.00 or�more .
for the en�ire proj ect , ancl such persons are not licensed as contractors or
subcontractors, �theri you maY be an enpxoyex. � ,
' 'If you are .an employer, you must �register t��ith the state and �ederal .
go�ernment as an emp�oyer and you are subject to several obligations
including s�ate and f ederal incvme �ax withholding, federal social security
taxes, , workers compensatiori insurance, disability insurar�ce costs, and .
uneinploynient compensation contribu�ions. •. .
There taay be fi.naricial risks for you if you do not carry out �these
obligatio;�s, and these risks are especial�.y serious .with respect to workers
compensa�ion insurance. . . •
For nore spec�fic information about your obligations under the f ederal
law, contact the Internal Revieta•Service• (and if you wish, the U.S. Snall
Business Adninistx'ation) _ For rore specific information about your
obligations under State law, contac4 the Departnent of Beriefit-Paynents and
the Division of 2ndustrial Accidents. . ,
If the structure is intended foz sa�e, property owners .who are not
licensed contractors are allo�•red to perform ,their work personally or throug;� •
their otan enployees . , without a licensed contractor or subcontractor; orily
under lini�ed conditions. . . � � ���
, A frequent practice of unlicensed persons professing to be contractors ,
� is to. secuze an "owner builder" buildi�g permit, erroneously imply�ng��tha:
the property owner is providing his or her own labar and material personally.
Building p�rnits are not required to be signed by property oomers unless they
.are, perforning their own work persorially. .
Infornatior► about licensed con�ractors may be obtained by contacting the
Contractor's State License •Board ln your conmunity or at 1020 N. Street
Sacramento, California 95814 . .
Please complete and� return 'the enc�osed "owner-builder" ..verification
form so that we can confirm tha� you are aF�are of these natters. Th�
' building permit t��ill not be issued un�il the veri.fi_catxon is returned.
CITY �OF DIPl•iOND BAR . . ' '
. � s� �.�.�-�� : . . . � . . � � �
c:�o. '
ennis A. � Tarango, . • �. - • •
' Building Official � • ' '� • '
� • •,, . . .
;�,,,..:�_ ,----__ . . • �.
. .
.n��%.. '^"'�'?����. .. • • • .
, ;•� • . • ' . � ' . . .
. �• • ' . • ' • � "
' � ' •' CiTY OF DIAMONb SAR • �
. ' . , OWNER-BUILDER APPLICANT �
. � ' S3 � • �o��aA.e�ss: .
. . • i � .
. ' -- /`7�,
Attention Property owner: . _
An 'otivner-bu i 1 der' �bu i 1 d i ng perm i t has. been app 1 i ed� for i n your � '
name and bearing your slgnature. �
� . . P! ease conp l e�e and return tt�i s i nfo�nat i on at your. ear f i est � '
opportun i ty to avo i d unnecessary de 1 ay i n process i ng and i ssu i ng
. your bui Iding pernit. No bui•tding permit �wi 11 be lssued unti 1 this
verification is received. . � .
1 . I personally pian to provide the maJor� labor and materials fior
- construction o� #he proposed property improveinent (yes or ho)
2. i (havelhave n�t� � � signed an application for a
� • bu i 1 d i ng �,crm �t '�or t e proposed tvork. , • , �
. 3. i �ave contracted with the follor�ing person tfiirm) to provide �
' the proposed construction: . �
: • Name ddress. City��,'���
. . Phon � - ' ' Contracto'rs Llcen No. �
4. I p 1 an to prov i d� port i ons of -the �vork'. bu-t, t have h i red the . �
. • 'follovting person to coordinate, supervise. a .provide '�he major
v�ork : . .
• Name L���„�� ��;�. tit-�ddress � � City ' '
Phone ' Contractors License No. •� �
5. 1 will provide some ofi� the work but 1 have contracted (hired)
the �o l 1 o��r i ng' persons to prov i d'e the vrork 'i nd i cated: ^
, Mame . - Address � Phone Type of 1York '
, S i ghed�_ . � . - ,
• • � ^r-.t�perty �vner :
Social Security t�lumber� (� �-SZ � c�7 �C� � .
, Dste `� - aJ � q'� �. ' . . • .