Mission Viejo, CA · Orange County
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
Download The Form
Download the Contractor Permit Disclosure PDF.
- 2
Complete The Disclosure
Enter the property address, contractor and license information, and the applicable workers’ compensation declaration.
- 3
Sign And Date
The contractor or authorized agent signs and dates the applicable sections and completes the certification.
- 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.
