Alhambra, CA · Los Angeles County
Owner Builder Declaration & Authorization
Property owners named as the builder on a building permit use this form to acknowledge their responsibilities and provide required declarations and authorization.
What this form is
This form records a property owner's acknowledgment and verification when a building permit application names the owner as the builder. It asks the owner to initial statements about owner-builder responsibilities, complete a workers’ compensation declaration, and provide signatures and other project information. It also includes a construction lending agency declaration and authorizes a city representative to enter the property for inspections.
Who needs it
A property owner named as the builder on a building permit application should complete the form’s acknowledgments, declarations, and authorization.
How to submit it
The form identifies the City of Alhambra Building & Safety Division at 111 South 1st Street and lists [email protected]. It does not specify a submission method.
About notarization
This document is signed without a notary; the workers’ compensation and construction lending agency declarations are affirmed under penalty of perjury.
How to submit this form
- 1
Download The Form
Download the Owner Builder Declaration & Authorization PDF.
- 2
Complete The Form
Enter the property and permit information, initial the acknowledgments, complete applicable declarations, and sign and date.
- 3
Review Required Declarations
Complete the workers’ compensation declaration and, if applicable, provide the construction lending agency name.
- 4
Submit To The City
Contact the Building & Safety Division using the address or email printed on the form; it does not specify a submission method.
Frequently asked questions
- Do I need a notary for the Owner Builder Declaration?
- No. The form has signature lines but no notary block; its workers’ compensation and construction lending agency declarations are affirmed under penalty of perjury.
- Who completes the Owner Builder Declaration?
- The property owner named as the builder on a building permit application completes the acknowledgments, declarations, and authorization.
- What information does the form ask for?
- It asks for the property address, permit number, owner acknowledgments, workers’ compensation declaration, any construction lending agency name, and signatures and dates.
- How do I submit the Owner Builder Declaration?
- The form names the Building & Safety Division at 111 South 1st Street and lists [email protected], but does not specify a submission method.
Need something notarized?
This Owner Builder Declaration & Authorization doesn’t need a notary — but if you have another Alhambra form that does, a commissioned online notary can help.