Beverly Hills, CA · Los Angeles County
Owner-Builder Acknowledgement and Information Declarations
Property owners seeking an owner-builder building permit complete this form to declare their qualifications, workers’ compensation status, and project details.
What this form is
Beverly Hills requires an owner’s signature when a building permit is issued as an owner-builder permit. The form asks the property owner to identify the basis for exemption from contractor licensing, make a workers’ compensation declaration, provide lending agency information if applicable, and certify project and inspection-related statements.
Who needs it
Property owners applying for a building permit as an owner-builder need to complete the applicable declarations and sign the form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the owner-builder and workers’ compensation declarations are affirmed under penalty of perjury, and the signer signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Acknowledgement and Information Declarations PDF.
- 2
Complete Applicable Declarations
Select the applicable owner-builder and workers’ compensation declarations, and provide the requested project and lending agency information.
- 3
Sign And Date
Print your name, sign as the property owner or authorized agent, and enter the date where requested.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Owner-Builder Acknowledgement form for?
- It records an owner-builder’s licensing exemption, workers’ compensation declaration, lending agency information if applicable, and certifications related to a building permit.
- Who completes this owner-builder form?
- The property owner applying for a building permit as an owner-builder completes the applicable declarations. The form says an owner-builder permit must be signed by the owner.
- Do I need a notary for the Owner-Builder Acknowledgement?
- No. This document is signed without a notary; its owner-builder and workers’ compensation declarations are affirmed under penalty of perjury, and the signer signs and dates the form.
- How do I submit the Owner-Builder Acknowledgement?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Owner-Builder Acknowledgement and Information Declarations doesn’t need a notary — but if you have another Beverly Hills form that does, a commissioned online notary can help.