Cerritos, CA · Los Angeles County
Declaration Form (Owner-Builder / Contractor / Workers' Comp)
Property owners and contractors complete this declaration with permit information about licensing, workers’ compensation, hazardous materials, asbestos, and construction lending.
What this form is
This declaration collects statements and information for work covered by a building permit, including whether the property owner is acting as an owner-builder or a licensed contractor and how workers’ compensation requirements are met. It also asks about hazardous materials, asbestos notification, and any construction lending agency. The form includes project and property details and signatures from the property owner or authorized agent and, where applicable, the contractor.
Who needs it
Property owners or authorized agents and contractors involved in permitted construction work complete the applicable declarations and project information.
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 declaration is signed without a notary; its statements are made under penalty of perjury, and the signer signs and dates it.
How to submit this form
- 1
Download The Declaration
Download the Cerritos declaration PDF.
- 2
Complete Applicable Sections
Fill in the project and property details and the applicable owner-builder, contractor, and workers’ compensation declarations.
- 3
Review Related Responses
Complete the hazardous materials, asbestos notification, and construction lending agency sections as applicable.
- 4
Sign And Submit
Sign and date the declaration, then submit it to the city department named on the form.
Frequently asked questions
- What information does the Cerritos declaration request?
- It asks for owner-builder or contractor licensing declarations, workers’ compensation information, hazardous materials and asbestos responses, construction lending agency details, and project information.
- Who completes this declaration?
- The property owner or authorized agent completes the applicable owner and project declarations. A licensed contractor completes the contractor declaration when applicable.
- Do I need a notary for the Cerritos declaration?
- No. The document has no notary block; its statements are made under penalty of perjury, and the signer signs and dates it.
- How do I submit the Cerritos declaration?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Declaration Form (Owner-Builder / Contractor / Workers' Comp) doesn’t need a notary — but if you have another Cerritos form that does, a commissioned online notary can help.