Eureka, CA · Humboldt County
Owner-Builder Acknowledgment
Property owners applying for a construction permit as owner-builders complete this form to acknowledge their responsibilities and verify project information.
What this form is
Eureka requires the property owner to read, initial, sign, and return this acknowledgment before the city issues an owner-builder building permit. The form covers the owner’s responsibilities and risks, confirms the project address, and includes an agent authorization section for owners who designate someone to apply for the permit. A driver’s license copy or other acceptable signature verification is presented when the permit is issued.
Who needs it
Property owners applying for a construction permit in their own name as owner-builders need to complete and return this form.
How to submit it
Return the completed form to the Building Division at 531 K St, Eureka, CA 95501. The form lists [email protected] and (707) 441-4155.
About notarization
This document is signed without a notary; it lists form notarization as one possible signature-verification option, and the agent authorization includes a penalty-of-perjury declaration.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Acknowledgment form.
- 2
Complete The Acknowledgment
Read and initial each statement, enter the project address, and sign and date the owner acknowledgment.
- 3
Gather Signature Verification
Have a copy of the owner’s driver’s license or other verification acceptable to the agency ready for permit issuance.
- 4
Submit To The Building Division
Return the completed form to the Building Division at 531 K St, Eureka, CA 95501.
Frequently asked questions
- Do I need a notary for the Owner-Builder Acknowledgment?
- No. The form is signed without a notary. It lists form notarization as one possible signature-verification option when the permit is issued; the agent authorization includes a penalty-of-perjury declaration.
- Who completes the Owner-Builder Acknowledgment?
- The property owner applying for a construction permit as the owner-builder reads and initials the statements, provides project information, and signs the form.
- How do I submit the Owner-Builder Acknowledgment?
- Return the completed form to the Building Division at 531 K St, Eureka, CA 95501. The form also lists [email protected] and (707) 441-4155.
- Is the agent authorization section always required?
- No. The form says the authorization is required only when the property owner designates an agent to apply for an owner-builder construction permit.