Siskiyou County, CA · Siskiyou County

No notary required

Owner-Builder Acknowledgment and Information Verification Form

Property owners applying for a construction permit as an owner-builder use this form to acknowledge their responsibilities and verify project information.

At a glance

Issued by
City of Siskiyou County · Siskiyou County, Siskiyou County, California
Notarization
Not required: file this form without a notary.
Official source
siskiyoucounty.gov
Blank form
Download the PDF
Catalogued
Machine-readable
JSON record · about the forms index

What this form is

Siskiyou County requires the property owner to complete and return this form before issuing an owner-builder building permit. The owner reads and initials statements about owner-builder responsibilities, verifies information about the proposed construction, and signs and dates the form. If the owner designates an agent to apply for the permit, the package also includes an authorization form for the agent.

Who needs it

Property owners applying for a construction permit in their own name as the owner-builder need to complete and return this form.

How to submit it

Return the completed form to the Siskiyou County Building Division at 806 South Main Street, Yreka, California 96097, before the building permit is issued.

About notarization

No notary is required for this document; when the permit is issued, the owner’s signature must be verified by a driver’s license, notarization, or other verification the agency accepts.

How to submit this form

  1. 1

    Download the Form

    Download the Owner-Builder Acknowledgment and Information Verification Form.

  2. 2

    Read and Complete

    Read and initial each statement, enter the proposed construction information, and sign and date the form.

  3. 3

    Complete Agent Authorization

    If designating an agent to apply for the permit, complete the included authorization form.

  4. 4

    Return to the County

    Return the completed form to the Siskiyou County Building Division before the building permit is issued.

Frequently asked questions

Do I need a notary for the Owner-Builder Acknowledgment Form?
No notary is required to complete this form. When the permit is issued, the owner’s signature must be verified with a driver’s license, notarization, or other verification the agency accepts.
How do I submit the Owner-Builder Acknowledgment Form?
Return the completed form to the Siskiyou County Building Division at 806 South Main Street, Yreka, California 96097, before the building permit is issued.
When does the county require this form?
The property owner must read, initial, sign, and return the form before the county will issue an owner-builder building permit.
Do I need the agent authorization form?
The package says the authorization form is required only when the property owner designates an agent to apply for an owner-builder construction permit.

Need something notarized?

This Owner-Builder Acknowledgment and Information Verification Form doesn’t need a notary, but if you have another Siskiyou County form that does, a commissioned online notary can help.