Do I need a notary for the residential plumbing self-certification declaration?

No. The installer and property owner sign and date this declaration without a notary. The form does not mention any notarized or sworn attachment.

Who completes this self-certification declaration?

The form is completed by a California-licensed plumbing contractor or owner-builder participating in the program, and the property owner must also sign and date it.

What work can be listed on this declaration?

The form covers a dishwasher, garbage disposal, or water closet installed or replaced as described in the declaration.

How do I submit the residential plumbing self-certification declaration?

Return the completed form to the Newport Beach Building Division by mail at P.O. Box 1768, Newport Beach, CA 92658, or fax it to (949) 644-3250.

Newport Beach, CA · Orange County

No notary required

Contractor/Property Owner Self-Certification Declaration for Residential Properties

This voluntary declaration lets a licensed plumbing contractor or owner-builder and the property owner certify specified residential plumbing work for Newport Beach.

What this form is

This voluntary declaration is for residential dishwasher, garbage disposal, or water closet work completed under Newport Beach’s Self-Certification Program. It asks for the project and installer details, the type of work, and the installer’s certification and signatures; the property owner must also sign and date it. The completed form must be returned to the Building Division for final approval of the plumbing permit.

Who needs it

A California-licensed plumbing contractor or owner-builder and the property owner complete this form for eligible residential plumbing work under the program.

How to submit it

Return the completed form to the Building Division by mail at P.O. Box 1768, Newport Beach, CA 92658, or by fax at (949) 644-3250.

About notarization

This declaration is signed and dated by the installer and property owner without a notary; the form mentions no notarized or sworn attachment.

How to submit this form

1
Download The Declaration
Download the residential plumbing self-certification declaration.
2
Complete The Form
Enter the project and installer information, check the applicable work, and have the installer and property owner sign and date it.
3
Gather Attachments
The declaration does not identify any attachments to include.
4
Submit To The Building Division
Mail the completed form to the Building Division at P.O. Box 1768, Newport Beach, CA 92658, or fax it to (949) 644-3250.

Frequently asked questions

Do I need a notary for the residential plumbing self-certification declaration?: No. The installer and property owner sign and date this declaration without a notary. The form does not mention any notarized or sworn attachment.
Who completes this self-certification declaration?: The form is completed by a California-licensed plumbing contractor or owner-builder participating in the program, and the property owner must also sign and date it.
What work can be listed on this declaration?: The form covers a dishwasher, garbage disposal, or water closet installed or replaced as described in the declaration.
How do I submit the residential plumbing self-certification declaration?: Return the completed form to the Newport Beach Building Division by mail at P.O. Box 1768, Newport Beach, CA 92658, or fax it to (949) 644-3250.

Need something notarized?

This Contractor/Property Owner Self-Certification Declaration for Residential Properties doesn’t need a notary — but if you have another Newport Beach form that does, a commissioned online notary can help.