Benicia, CA · Solano County
Contractor/Authorized Agent Declarations
Contractors, property owners, and authorized agents complete this declaration form with project details and signatures for a Benicia building permit.
What this form is
This form collects project and property-owner information and declarations from a contractor, owner, or authorized agent for building permit work. It asks for contractor license details, a workers’ compensation declaration, and signatures confirming the information and agreement to comply with applicable requirements. The form also includes general permit conditions, including inspection and work requirements.
Who needs it
Contractors, property owners, or authorized agents involved in building permit work complete the form and provide the applicable declarations and signatures.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form identifies the Community Development Department Building Division.
About notarization
This document is signed without a notary; it includes declarations under penalty of perjury, and the signer initials one workers’ compensation option and signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Contractor/Authorized Agent Declarations PDF.
- 2
Complete Project Information
Enter the property address, owner contact information, and work description.
- 3
Complete Declarations
Provide contractor license details, initial one workers’ compensation option, and complete the applicable signatures and dates.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Contractor/Authorized Agent Declarations?
- No. The form has no notary block. It includes declarations under penalty of perjury, and the signer initials one workers’ compensation option and signs and dates the form.
- Who completes this declaration form?
- A contractor, property owner, or authorized agent completes the form with project information and the applicable declarations and signatures.
- What information does the form request?
- It requests the property address, owner contact details, work description, contractor license information, a workers’ compensation declaration, and signatures.
- How do I submit the Contractor/Authorized Agent Declarations?
- Submit it to the city department named on the form; check the city website for current contact details. The form identifies the Community Development Department Building Division.
Need something notarized?
This Contractor/Authorized Agent Declarations doesn’t need a notary — but if you have another Benicia form that does, a commissioned online notary can help.