Alhambra, CA · Los Angeles County
Licensed Contractor Declaration
Contractors complete this form to provide license, workers’ compensation, construction lending, and property-entry declarations for work requiring a city permit.
What this form is
This form collects a contractor’s license details and declarations about workers’ compensation coverage, any construction lending agency, and authorization for city inspection entry. It is for work covered by the permit identified on the form. The contractor provides the property address and permit number, completes the applicable declarations, and signs and dates the relevant sections.
Who needs it
A licensed contractor applying for a building permit for work at a property in Alhambra needs to complete the applicable declarations.
How to submit it
The form lists the Building & Safety Division at 111 South 1st Street, [email protected], and (626) 570-5032. It does not state a submission method.
About notarization
This document is signed without a notary; the workers’ compensation and construction lending declarations are affirmed under penalty of perjury, and the signer dates the applicable sections.
How to submit this form
- 1
Download The Form
Download the Licensed Contractor Declaration PDF.
- 2
Complete The Applicable Sections
Enter the property address, permit number, license details, and applicable workers’ compensation and lending declarations.
- 3
Sign And Date
Sign and date the applicable sections, including the authorization of entry.
- 4
Contact The Division
The form lists the Building & Safety Division’s address, email, and phone number; it does not specify a submission method.
Frequently asked questions
- What is the Licensed Contractor Declaration?
- It is a form for contractors to provide license information and declarations about workers’ compensation, construction lending, and authorization for city inspection entry.
- Who completes this form?
- A licensed contractor completes the form for work covered by the permit identified on it, filling in the applicable declarations and signing and dating the sections.
- Do I need a notary for the Licensed Contractor Declaration?
- No. This document is signed without a notary. The workers’ compensation and construction lending declarations are affirmed under penalty of perjury, and the signer dates the applicable sections.
- How do I submit the Licensed Contractor Declaration?
- The form lists the Building & Safety Division at 111 South 1st Street, [email protected], and (626) 570-5032, but does not state a submission method.
Need something notarized?
This Licensed Contractor Declaration doesn’t need a notary — but if you have another Alhambra form that does, a commissioned online notary can help.