Lodi, CA · San Joaquin County
Owner-Builder Supplemental Form
Property owners applying for a construction permit as an owner-builder use this form to acknowledge their responsibilities and verify project information.
What this form is
The form explains owner-builder responsibilities and requires the property owner to read and initial each statement, provide the project address, and sign and date the acknowledgment. Lodi says it must be completed and returned before a building permit can be issued. An authorization section is included for owners designating an agent to apply for an owner-builder permit.
Who needs it
Property owners applying for a construction permit as an owner-builder must complete and return the acknowledgment before the city issues the permit.
How to submit it
Return the completed form to the Community Development Department, Building Inspection Division, at 221 West Pine St., PO Box 3006, Lodi, CA 95241-1910.
About notarization
This form has no notary block; at permit issuance, the city requires a driver’s license copy, notarization, or other acceptable verification of the owner’s signature.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Supplemental Form for your owner-builder construction permit application.
- 2
Complete The Acknowledgment
Read and initial each statement, enter the project address, and sign and date the owner acknowledgment.
- 3
Complete Agent Authorization If Needed
If designating an agent, complete the authorization section with the project and agent information.
- 4
Return It To The City
Return the completed form to the Community Development Department, Building Inspection Division, at the address shown on the form.
Frequently asked questions
- Do I need a notary for the Owner-Builder Supplemental Form?
- No. The form has no notary block, but at permit issuance it requires a driver’s license copy, notarization, or other verification acceptable to the agency.
- How do I submit the Owner-Builder Supplemental Form?
- Return the completed form to the Community Development Department, Building Inspection Division, at 221 West Pine St., PO Box 3006, Lodi, CA 95241-1910.
- Who completes the Owner-Builder Supplemental Form?
- The property owner applying for a construction permit as an owner-builder reads and initials the statements, provides project information, and signs and dates the form.
- Is the agent authorization section always required?
- No. The form says the property owner completes the Authorization of Agent section only when designating an agent to apply for an owner-builder construction permit.