How do I submit the Owner-Builder Application?

Complete and sign the form, then return it to the agency responsible for issuing the permit. The form lists San Leandro’s Building and Safety Services Division.

When does the city require this form?

The completed form must be returned before a building permit can be issued for construction applied for in the property owner’s name as an owner-builder.

San Leandro, CA · Alameda County

No notary required

Owner-Builder Acknowledgement and Application

Property owners applying for a construction permit as an owner-builder use this form to acknowledge their responsibilities and provide project and owner information.

What this form is

The form explains owner-builder responsibilities and asks the property owner to read and initial statements, verify information, and sign and date the acknowledgement. The city requires the completed form before it issues a building permit. If the owner authorizes an agent to apply, the form also collects the agent’s details and project information.

Who needs it

Property owners applying for a construction permit as an owner-builder must complete and return this form before the permit can be issued.

How to submit it

Complete and sign the form, then return it to the agency responsible for issuing the permit. The form identifies the Building and Safety Services Division at 835 East 14th Street, San Leandro, CA 94577.

About notarization

The document is signed without a notary; when the permit is issued, the owner must present a driver’s license copy, a notarized form, or other verification acceptable to the agency.

How to submit this form

1
Download The Form
Download the Owner-Builder Acknowledgement and Application.
2
Complete The Form
Read and initial the statements, provide the requested project and owner information, and sign and date the form.
3
Gather Verification
When the permit is issued, present a copy of the owner’s driver’s license, a notarized form, or other verification acceptable to the agency.
4
Return The Form
Return the completed form to the agency responsible for issuing the permit.

Frequently asked questions

Do I need a notary for the Owner-Builder Acknowledgement and Application?: The form is signed without a notary, but when the permit is issued, the owner must present a driver’s license copy, a notarized form, or other verification acceptable to the agency.
How do I submit the Owner-Builder Application?: Complete and sign the form, then return it to the agency responsible for issuing the permit. The form lists San Leandro’s Building and Safety Services Division.
When does the city require this form?: The completed form must be returned before a building permit can be issued for construction applied for in the property owner’s name as an owner-builder.

Need something notarized?

This Owner-Builder Acknowledgement and Application doesn’t need a notary — but if you have another San Leandro form that does, a commissioned online notary can help.