Costa Mesa, CA · Orange County
Declaration of Authorization for Agents of Contractor to Apply for Permits
Contractors use this declaration to authorize named agents to obtain Costa Mesa permits on their behalf.
What this form is
This declaration records a contractor’s authorization for named people to obtain permits on the contractor’s behalf. It also states that the contractor will file a workers’ compensation insurance certificate before permits are issued, and that the authorization continues until the Building Division receives written cancellation. The form asks for agent and contractor details, signatures, and a copy of the state contractor’s license.
Who needs it
A contractor who wants one or more agents to obtain Costa Mesa permits on their behalf needs to complete this declaration.
How to submit it
Submit the form to the Development Services Department, Building Division, at 77 Fair Drive, Costa Mesa, CA 92626. The form also lists the department phone number as 714-754-5273.
About notarization
The contractor signs and dates this declaration without a notary; attach a copy of the state contractor’s license and file a workers’ compensation insurance certificate before permits are issued.
How to submit this form
- 1
Download The Form
Download the contractor agent authorization declaration.
- 2
Complete The Declaration
Enter the agents’ details and contractor information, then sign and date the declaration.
- 3
Gather Attachments
Attach a copy of the state contractor’s license and file the workers’ compensation insurance certificate before permits are issued.
- 4
Submit To The City
Submit the completed form to the Development Services Department, Building Division, at 77 Fair Drive.
Frequently asked questions
- What does the contractor agent authorization form do?
- It lets a contractor name people authorized to obtain permits on the contractor’s behalf and records the contractor’s agreement and information.
- What should I attach to the declaration?
- The form says to attach a copy of the state contractor’s license. It also states that a workers’ compensation insurance certificate must be filed before permits are issued.
- Do I need a notary for the contractor agent authorization form?
- No. The contractor signs and dates this declaration; attach a copy of the state contractor’s license and file a workers’ compensation insurance certificate before permits are issued.
- How do I submit the contractor agent authorization form?
- Submit it to the Development Services Department, Building Division, at 77 Fair Drive, Costa Mesa, CA 92626.
Need something notarized?
This Declaration of Authorization for Agents of Contractor to Apply for Permits doesn’t need a notary — but if you have another Costa Mesa form that does, a commissioned online notary can help.