Do I need a notary for the Owner-Builder Acknowledgment Form?

No. The form does not require notarization, though it lists form notarization as one option for verifying the owner’s signature when the permit is issued.

How do I submit the Owner-Builder Acknowledgment Form?

Return the completed form to the Building Division at 1400 5th Avenue, San Rafael, CA 94901. The owner’s signature must be verified when the permit is issued.

When is this form required?

The city must receive the completed and signed form before issuing a building permit applied for in the property owner’s name as the Owner-Builder.

Can I authorize an agent to apply for the permit?

Yes. The form includes an agent authorization section for the property owner to name an agent and describe the project and work.

San Rafael, CA · Marin County

No notary required

Owner-Builder Acknowledgment Form

Property owners applying for a construction permit in their own name complete this form to acknowledge Owner-Builder responsibilities and verify project information.

What this form is

The form explains the responsibilities and potential risks of obtaining a building permit as an Owner-Builder. The city requires the property owner to read and initial each statement, provide project and property information, and sign and return the form before a permit can be issued. It also includes an optional agent authorization section for owners designating someone to apply for the permit.

Who needs it

Property owners applying for a construction permit as the Owner-Builder must complete and return this acknowledgment before the permit can be issued.

How to submit it

Return the completed form to the Building Division at 1400 5th Avenue, San Rafael, CA 94901. The document says the owner’s signature must be verified when the permit is issued.

About notarization

This form is signed without a notary; the city may accept form notarization as one signature-verification option, and the agent authorization includes a declaration under penalty of perjury.

How to submit this form

1
Download The Form
Download the Owner-Builder Acknowledgment Form.
2
Read And Complete It
Read and initial each statement, complete the project information, and sign and date the form.
3
Complete Agent Authorization If Needed
If you are designating an agent, complete the authorization section with the agent and project information.
4
Return It To The City
Return the form to the Building Division at 1400 5th Avenue, San Rafael, CA 94901.

Frequently asked questions

Do I need a notary for the Owner-Builder Acknowledgment Form?: No. The form does not require notarization, though it lists form notarization as one option for verifying the owner’s signature when the permit is issued.
How do I submit the Owner-Builder Acknowledgment Form?: Return the completed form to the Building Division at 1400 5th Avenue, San Rafael, CA 94901. The owner’s signature must be verified when the permit is issued.
When is this form required?: The city must receive the completed and signed form before issuing a building permit applied for in the property owner’s name as the Owner-Builder.
Can I authorize an agent to apply for the permit?: Yes. The form includes an agent authorization section for the property owner to name an agent and describe the project and work.

Need something notarized?

This Owner-Builder Acknowledgment Form doesn’t need a notary — but if you have another San Rafael form that does, a commissioned online notary can help.