Antioch, CA · Contra Costa County
Licensed Contractor / Owner-Builder Declaration
Property owners complete this declaration for an Antioch building permit when acting as owner-builders and acknowledging project responsibilities.
What this form is
This form records owner and project details, the owner-builder’s declaration, and the property owner’s acknowledgements and certifications. It asks the owner to indicate responsibility for performing or supervising work, initial applicable requirements, and sign and date the certification. The document states that additional approvals may be required and that work is subject to inspection.
Who needs it
Property owners acting as owner-builders for a building project in Antioch use this form to declare their role and acknowledge project requirements.
How to submit it
The form lists the Community Development Department, Building Division, at 200 H Street, Antioch, CA 94509, and [email protected]. It does not specify a submission method.
About notarization
This document is signed without a notary; the property owner signs and dates the declaration and certification.
How to submit this form
- 1
Download The Form
Download the Licensed Contractor / Owner-Builder Declaration PDF.
- 2
Complete Owner And Project Details
Enter the permit number, project address, APN, and owner contact information, then complete the owner-builder declaration.
- 3
Review And Initial Requirements
Read the acknowledgement and special requirements, and initial each listed item as directed.
- 4
Sign And Contact The Building Division
Sign and date the owner certification. The form lists the Building Division’s address and email but does not specify a submission method.
Frequently asked questions
- Do I need a notary for the Owner-Builder Declaration?
- No. The document has signature and date fields for the property owner but no notary block; the owner signs and dates the declaration and certification.
- Who completes the Owner-Builder Declaration?
- A property owner acting as an owner-builder completes the form with owner and project information, makes the owner-builder declaration, and signs the certification.
- What does the form ask the property owner to acknowledge?
- It asks the owner to initial items about permit and project requirements, certify understanding of owner-builder responsibilities, and confirm the information is true and correct.
- How do I submit the Owner-Builder Declaration?
- The form lists Antioch’s Community Development Department, Building Division, at 200 H Street and [email protected]. It does not specify how to submit the form.