Mission Viejo, CA · Orange County

No notary required

Contractor Permit Disclosure

Contractors complete this disclosure for work covered by a city permit, providing property, license, and workers’ compensation information and signing declarations.

What this form is

The Contractor Permit Disclosure records information and declarations for a contractor performing work for which a city permit is issued. It asks for the property address, contractor and license details, and a workers’ compensation declaration, including coverage or insurance information when applicable. The contractor or authorized agent signs and dates the form and certifies the application information.

Who needs it

A contractor or authorized agent completing disclosures for work for which a city permit is issued needs this form.

How to submit it

The form lists the Building Services Division at 200 Civic Center, Mission Viejo, CA 92691, and phone (949) 470-3054; it does not specify a submission method.

About notarization

This document is signed without a notary; the contractor makes declarations under penalty of perjury, but the form does not identify a notarized attachment or related step.

How to submit this form

  1. 1

    Download The Form

    Download the Contractor Permit Disclosure PDF.

  2. 2

    Complete The Disclosure

    Enter the property address, contractor and license information, and the applicable workers’ compensation declaration.

  3. 3

    Sign And Date

    The contractor or authorized agent signs and dates the applicable sections and completes the certification.

  4. 4

    Contact Building Services

    The form lists the Building Services Division address and phone number; it does not state a submission method.

Frequently asked questions

Do I need a notary for the Contractor Permit Disclosure?
No. The form is signed without a notary, though the contractor makes declarations under penalty of perjury.
How do I submit the Contractor Permit Disclosure?
The form lists the Building Services Division at 200 Civic Center, Mission Viejo, CA 92691, and phone (949) 470-3054, but does not specify how to submit it.
What information does the form ask for?
It asks for the property address, contractor and license details, workers’ compensation information or declaration, and signatures and dates.

Need something notarized?

This Contractor Permit Disclosure doesn’t need a notary — but if you have another Mission Viejo form that does, a commissioned online notary can help.