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

No. The form has no notary block; the property owner signs and dates it. An agent authorization includes a declaration under penalty of perjury.

How do I submit the Owner-Builder Acknowledgment?

Return the completed and signed form to the permitting agency at the official address indicated on the application.

When must I return this form?

The form states that the permitting agency will not issue a building permit until the owner has read, initialed, signed, and returned it.

When is the agent authorization section required?

The form says the property owner completes the authorization only when designating an agent to apply for an owner-builder construction permit.

Los Banos, CA · Merced County

No notary required

Owner-Builder Acknowledgment and Information Verification Form

Property owners seeking a building permit as an owner-builder complete and return this form to acknowledge their responsibilities and verify project information.

What this form is

The form explains owner-builder responsibilities and risks, then asks the property owner to initial statements, provide project information, and sign and date the acknowledgment. The city says it must be completed and returned before a building permit can be issued. A separate agent authorization section is required only when the owner designates someone to apply for an owner-builder permit.

Who needs it

Property owners applying for a building permit as an owner-builder must complete and return the acknowledgment before the permit can be issued.

How to submit it

Complete and sign the form, then return it to the permitting agency at its official address indicated on the application. The form says signature verification is required when the permit is issued.

About notarization

No notary is required for this form; the owner signs and dates it, and an agent authorization includes a declaration under penalty of perjury.

How to submit this form

1
Download The Form
Download the Owner-Builder Acknowledgment and Information Verification Form.
2
Read And Complete It
Read and initial each acknowledgment statement, fill in the project information, and sign and date the form.
3
Complete Agent Authorization If Needed
If designating an agent to apply for the permit, complete the separate authorization section.
4
Return The Form
Return the completed form to the permitting agency at the official address indicated on the application.

Frequently asked questions

Do I need a notary for the Owner-Builder Acknowledgment?: No. The form has no notary block; the property owner signs and dates it. An agent authorization includes a declaration under penalty of perjury.
How do I submit the Owner-Builder Acknowledgment?: Return the completed and signed form to the permitting agency at the official address indicated on the application.
When must I return this form?: The form states that the permitting agency will not issue a building permit until the owner has read, initialed, signed, and returned it.
When is the agent authorization section required?: The form says the property owner completes the authorization only when designating an agent to apply for an owner-builder construction permit.

Need something notarized?

This Owner-Builder Acknowledgment and Information Verification Form doesn’t need a notary — but if you have another Los Banos form that does, a commissioned online notary can help.