Dana Point, CA · Orange County
Owner Builder Verification and Acknowledgment Form
Property owners seeking a building permit as owner-builders complete and return this form to verify their understanding and acknowledge their responsibilities.
What this form is
This form documents a property owner’s awareness of the responsibilities and risks of acting as an owner-builder, and identifies the basis for claimed exemption from contractor licensing. The City requires the completed, signed form before issuing a building permit. It asks for the project address, checked acknowledgments and exemption statements, and the owner’s or authorized agent’s printed name, signature, and date.
Who needs it
Property owners named as the builder on a building permit application must complete this form before the City can issue the permit.
How to submit it
Complete and sign the form, then return it to the City of Dana Point before the building permit is issued. The form lists Community Development, Building and Safety, at 33282 Golden Lantern, Suite 209, Dana Point, CA 92629.
About notarization
This document is signed without a notary; it includes the owner’s affirmation under penalty of perjury, and the signer signs and dates the form.
How to submit this form
- 1
Download the Form
Download the Owner Builder Verification and Acknowledgment Form.
- 2
Complete the Form
Enter the project address and check the statements that apply to your owner-builder responsibilities and exemption.
- 3
Sign and Date
Print the owner’s or authorized agent’s name, then sign and date the form.
- 4
Return It to the City
Return the completed form to the City of Dana Point before the building permit is issued.
Frequently asked questions
- Do I need a notary for the Owner Builder Verification and Acknowledgment Form?
- No. The document does not require notarization. It does include an affirmation under penalty of perjury, which the owner or authorized agent signs and dates.
- How do I submit the Owner Builder Verification and Acknowledgment Form?
- Complete and sign the form, then return it to the City of Dana Point before the building permit is issued. The form lists Community Development, Building and Safety, at 33282 Golden Lantern, Suite 209.
- What information does the form ask for?
- The form asks for the project address, checked acknowledgments and exemption statements, and the owner’s or authorized agent’s printed name, signature, and date.