Do I need a notary for the Owner-Builder Acknowledgement?

No. The form calls for initials, the property owner's signature, and a date, but no notary. Attach a subcontractor list or workers compensation insurance when applicable.

What information does the form ask for?

It asks for the owner's name and property address, the owner-builder role, initials acknowledging each statement, a phone number, signature, and date.

What attachments may be required?

If acting as a contractor, attach a completed list of subcontractors. If acting as an employer, attach workers compensation insurance for the listed workers.

San Leandro, CA · Alameda County

No notary required

Owner-Builder Acknowledgement of Risks, Responsibilities & Liabilities

Property owners applying for an owner-builder building permit use this form to acknowledge construction risks and responsibilities to the City of San Leandro.

What this form is

This form records a property owner's choice to act as an owner-builder when applying for a building permit and acknowledges the risks and responsibilities involved. The city asks the owner to read and initial each statement, select an owner-builder role, and sign and date the form. Depending on the selected role, the form also calls for a subcontractor list or workers compensation insurance attachment.

Who needs it

Property owners applying for an owner-builder building permit need to complete this form and bring it with photo identification to the Permit Center.

How to submit it

Bring the completed form and your photo I.D. to the Permit Center to process your owner-builder building permit. For questions, email [email protected].

About notarization

This document is signed and dated without a notary; initial each statement and attach a subcontractor list or workers compensation insurance when applicable.

How to submit this form

1
Download The Form
Download the Owner-Builder Acknowledgement form.
2
Complete The Form
Enter the property owner's name and address, select an owner-builder role, and initial each statement.
3
Gather Attachments
Attach a completed subcontractor list or workers compensation insurance when applicable.
4
Sign And Submit
Sign and date the form, then bring it with photo I.D. to the Permit Center.

Frequently asked questions

Do I need a notary for the Owner-Builder Acknowledgement?: No. The form calls for initials, the property owner's signature, and a date, but no notary. Attach a subcontractor list or workers compensation insurance when applicable.
How do I submit the Owner-Builder Acknowledgement?: Bring the completed form and your photo I.D. to the Permit Center to process your owner-builder building permit.
What information does the form ask for?: It asks for the owner's name and property address, the owner-builder role, initials acknowledging each statement, a phone number, signature, and date.
What attachments may be required?: If acting as a contractor, attach a completed list of subcontractors. If acting as an employer, attach workers compensation insurance for the listed workers.

Need something notarized?

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