Humboldt County, CA · Humboldt County
Owner Builder Acknowledgment and Information Verification Form
Humboldt County property owners complete this form to acknowledge the responsibilities and risks of obtaining a building permit as an owner-builder.
At a glance
- Issued by
- City of Humboldt County · Humboldt County, Humboldt County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- humboldtgov.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The form records a property owner’s acknowledgment of responsibilities and potential risks when a building permit is applied for in the owner’s name. The county says it must be completed and returned before a building permit can be issued. It asks the owner to read and initial statements, confirm the proposed construction address and responsibilities, then sign and date the form.
Who needs it
Property owners listed as owner-builders on a Humboldt County building permit application must complete and return this form before the permit is issued.
How to submit it
Return the completed form to the Building Division of the Humboldt County Planning and Building Department, 3015 H Street, Eureka, CA 95501. The form lists [email protected] and says signature verification is required at permit issuance.
About notarization
This form has no notary block; at permit issuance, the county requires a driver’s-license copy, notarization of the form, or other verification acceptable to the agency.
How to submit this form
- 1
Download the Form
Download the Owner Builder Acknowledgment and Information Verification Form.
- 2
Read and Complete It
Read and initial each provision, provide the requested information, and sign and date the second page.
- 3
Prepare Signature Verification
At permit issuance, present a copy of the property owner's driver's license, notarization of the form, or other verification acceptable to the agency.
- 4
Return It to the County
Return the completed form to the Building Division of the Humboldt County Planning and Building Department.
Frequently asked questions
- What does the Owner Builder Acknowledgment form do?
- It documents a property owner’s acknowledgment of responsibilities and risks when applying for a building permit as the owner-builder.
- Who needs to complete this form?
- The property owner named as the owner-builder on a building permit application must complete and return it before the county issues the permit.
- Do I need a notary for the Owner Builder Acknowledgment form?
- The form has no notary block. At permit issuance, the county requires a driver’s-license copy, notarization of the form, or other verification acceptable to the agency.
- How do I submit the Owner Builder Acknowledgment form?
- Return it to the Building Division of the Humboldt County Planning and Building Department at 3015 H Street, Eureka, CA 95501.