Orland, CA · Glenn County
Owner-Builder Acknowledgment and Information Verification Form
Property owners seeking an owner-builder building permit complete and return this form to acknowledge responsibilities and verify information for the proposed construction.
What this form is
Orland requires this form before issuing an owner-builder building permit. The property owner reads and initials statements about construction responsibilities, worker injuries, insurance, and potential employer obligations, then provides project and owner information and signs and dates the form. It also includes an optional authorization for an agent to act on the owner’s behalf.
Who needs it
Property owners applying for an owner-builder building permit in Orland must complete and return the form before the city issues the permit.
How to submit it
Complete and sign the form, then return it to the City of Orland Building Department at 815 Fourth Street, Orland, CA 95963. The form says the owner's signature must be verified when the permit is issued.
About notarization
This form has no notary jurat or acknowledgment block and does not require notarization; it says a driver's license, notarization, or other accepted verification may be used to verify the owner's signature.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Acknowledgment and Information Verification Form.
- 2
Read And Complete
Read and initial each statement, fill in the requested owner and project information, and sign and date the form.
- 3
Gather Verification
The form says the owner's signature must be verified when the permit is issued; a driver's license, notarization, or other accepted verification may be used.
- 4
Return To The City
Return the completed form to the City of Orland Building Department at 815 Fourth Street, Orland, CA 95963.
Frequently asked questions
- Do I need a notary for the Owner-Builder Form?
- No. The form has no notary block and does not require notarization, though it lists notarization as one possible way to verify the owner's signature when the permit is issued.
- Who completes the Owner-Builder Form?
- The property owner applying for an owner-builder building permit reads and initials the statements, provides project information, and signs and dates the form.
- How do I submit the Owner-Builder Form?
- Return the completed form to the City of Orland Building Department at 815 Fourth Street, Orland, CA 95963.
