Anaheim, CA · Orange County
Owner-Builder Acknowledgment and Information Verification Form
Property owners named as owner-builders on a building permit complete this form to acknowledge construction responsibilities and verify information before the city issues the permit.
What this form is
Anaheim requires this form before issuing a building permit applied for in a property owner’s name as the owner-builder. The owner reads and initials 12 statements, verifies the proposed construction address, and signs and dates the form. The statements explain owner-builder responsibilities and risks, including responsibility for construction activity and obligations when engaging workers.
Who needs it
A property owner named as the owner-builder on a building permit must complete and return this form before the permit can be issued.
How to submit it
Return the completed form to the agency responsible for issuing the permit at 200 S. Anaheim Blvd., Suite 145, Anaheim, California 92805; present the required signature verification when the permit is issued.
About notarization
This form is signed and dated without a notary; when the permit is issued, present a driver’s-license copy, form notarization, or other verification acceptable to the agency.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Acknowledgment and Information Verification Form.
- 2
Read And Complete The Form
Read and initial each of the 12 statements, verify the proposed construction address, then sign and date the form.
- 3
Gather Signature Verification
When the permit is issued, present a copy of the property owner’s driver’s license, form notarization, or other verification acceptable to the agency.
- 4
Return The Form
Return the completed form to the agency responsible for issuing the permit at the official address stated on the form.
Frequently asked questions
- Do I need a notary for the Owner-Builder Acknowledgment?
- No. The form is signed and dated without a notary, but when the permit is issued, present a driver’s-license copy, form notarization, or other verification acceptable to the agency.
- How do I submit the Owner-Builder Acknowledgment?
- Return the completed form to the permit-issuing agency at 200 S. Anaheim Blvd., Suite 145, Anaheim, California 92805. Present the required signature verification when the permit is issued.
- Who completes the Owner-Builder Acknowledgment?
- The property owner completes it when a building permit is applied for in the owner’s name as the owner-builder. An agent cannot execute the notice without prior approval from the permitting authority.
Need something notarized?
This Owner-Builder Acknowledgment and Information Verification Form doesn’t need a notary — but if you have another Anaheim form that does, a commissioned online notary can help.