Mountain House, CA · San Joaquin County
Owner-Builder Acknowledgment and Information Verification Form
Property owners applying for a building permit as owner-builders complete this form to acknowledge their responsibilities and verify project information.
What this form is
The form records a property owner’s understanding of owner-builder responsibilities and confirms consent to have a building permit issued in the owner’s name. The city requires the completed form before issuing an owner-builder permit. Owners read and initial each statement, provide the project address and sign and date the form; a separate agent authorization section is included when the owner designates someone to apply for the permit.
Who needs it
Property owners seeking a building permit in their own names as owner-builders must complete and return this form before the permit can be issued.
How to submit it
Complete and sign the form, then return it to the agency responsible for issuing the permit at the official address indicated on the application. The form says an agent may not execute the acknowledgment without prior approval from the permitting authority.
About notarization
The form is signed and dated without a notary block; at permit issuance, the owner must present a driver’s-license copy, notarization, or other verification accepted by the agency.
How to submit this form
- 1
Download The Form
Download the Owner-Builder Acknowledgment and Information Verification Form.
- 2
Read And Complete It
Read and initial each statement, fill in the project information, and sign and date the form.
- 3
Gather Verification
At permit issuance, present a driver’s-license copy, notarization, or other verification accepted by the agency.
- 4
Return It To The Agency
Return the completed form to the permit-issuing agency at the official address indicated on the application.
Frequently asked questions
- Do I need a notary for the Owner-Builder Acknowledgment Form?
- No notary block is provided for signing the form. At permit issuance, the form says to present a driver’s-license copy, notarization, or other verification accepted by the agency.
- Who completes the Owner-Builder Acknowledgment Form?
- The property owner completes it when applying for a building permit in their own name as the owner-builder. An agent cannot execute the acknowledgment without prior permitting-authority approval.
- How do I submit the Owner-Builder Acknowledgment Form?
- Return the completed and signed form to the agency responsible for issuing the permit, at the official address indicated on the application.
- When is the form required?
- The form must be completed, signed, and returned before the building permit can be issued.
Need something notarized?
This Owner-Builder Acknowledgment and Information Verification Form doesn’t need a notary — but if you have another Mountain House form that does, a commissioned online notary can help.