Building Permit Application - Part B

The individual listed below will be the permit applicant and holder of record. They will be solely responsible and liable for the permit(s) issued for this application, as well as for the construction performed under said permit(s). Additionally, they will serve as the responsible contact for this project until the associated permit(s) are finaled and closed.

Please add property tenant contact information if applicable for this jobsite.

Under penalty of perjury and by my initials below, I affirm each of the following:

I agree to prevent the existence or creation of any Unfinished-construction Nuisance, as defined in Section 19.04.053 of Marin County Code, for any scope of work authorized by issuance of this permit application and at the project location identified in this permit application. Furthermore, I acknowledge and agree that my violation of this agreement may make me subject to substantial monetary penalties in accordance with Section 19.04.053 of Marin County Code.

I acknowledge, agree and affirm that issuance of this permit application does not express or imply approval for any current or prior construction, use or occupancy other than the specific scopes of construction, use or occupancy declared in this permit application as the basis for permit issuance and evidenced in the submitted project documentation. Current or prior construction performed without proper permits is specifically excluded from any approvals expressed or implied under this/these building permit(s).

I acknowledge, agree and affirm that the building permit(s) issued as a result of this application, including any or all of the permissions granted under said permit(s), may be denied, voided or revoked by the County of Marin on the basis of incomplete or inaccurate information or my failure to demonstrate compliance with any of the specific requirements of said permit(s). I further acknowledge, agree, and affirm that the approvals necessary to issue and finalize said permit(s) are not guaranteed and are subject to review of information provided for this project and my evidence of work performed in compliance with the requirements of said permit(s).

I declare under penalty of perjury that I have reviewed the Senate Bill (SB) 407 Guide, available on the County of Marin’s website, and understand that, pursuant to Civil Code sections 1101.1-8, all building alterations or improvements to real property require the permit applicant to replace non-compliant plumbing fixtures with water conserving plumbing fixtures as a condition for issuance of a certificate of final completion and occupancy or final permit approval.

I also understand that certain types of work such as renewable energy systems (e.g., solar photovoltaic installations), electric vehicle charging stations, and energy storage systems (ESS batteries) are exempt from this requirement.

I declare under penalty of perjury that, pursuant to the requirements of Section 13113.7 of the California Health and Safety Code, I have installed, or will install, smoke alarms that are approved and listed by the State Fire Marshal within each dwelling unit affected by this/these permit(s). Smoke alarms compliant with Section R314 of the California Residential Code are installed, or will be installed: 1) In each sleeping room; 2) Immediately outside each separate sleeping area; 3) On each story of each dwelling unit, including basements and habitable attics; 4) On the upper level of split level floors without an intervening wall. Compliance must be verified prior to permit closure.

I declare under penalty of perjury that, pursuant to the requirements of Section 17926 of the California Health and Safety Code and Section R315 of the California Residential Code, I have installed, or will install, carbon monoxide alarms that are approved and listed by the State Fire Marshal within each dwelling unit affected by this/these permit(s) that contain either 1) a fuel-fired appliance or fireplace; or 2) an attached garage with an opening into the dwelling unit. Carbon monoxide alarms compliant with Section R315 of the California Residential Code are installed, or will be installed: 1) In each sleeping room (or sleeping room with attached bathroom) containing a fuel-burning appliance; and 2) Immediately outside each separate sleeping area. Compliance must be verified prior to permit closure.

I agree to strictly follow any/all applicable current construction safety protocols, as required by the Marin County Health Officer and strictly enforce these same construction safety protocols on the job site for this/these permit(s), until said permit(s) are finaled and closed.

I agree to comply with all applicable construction and demolition requirements as set forth by Cal Green Code and I acknowledge that this/these permit(s) will not be finaled and closed until such compliance is made evident to the issuer of this/these permit(s).

I acknowledge, agree and affirm that as a condition of my final inspection for this building permit I will be required to demonstrate that any existing gates larger than 48” in width, and/or 84” in height on this jobsite have compliant fall-over protection safeguards installed, and are verified by inspection prior to permit closure (Sec. 19.14.020, MCC).

We are providing you with the following Property Owner's Acknowledgment and Verification to make sure you are aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue this(these) building permit(s) until you have read, initialed your understanding of each provision, signed, and submitted this form.

Directions:  Read and initial each statement below to signify you understand and verify this information.

I understand a frequent practice of unlicensed persons is to have the property owner obtain an “Owner-Builder” building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner’s insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property.

I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.

I understand as an “Owner-Builder” I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own.

I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts.

I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law.

I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.

I understand under California Contractors' State License Law, an Owner-Builder who builds single family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor.

I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials.

I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.

I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address:

I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers.

I agree to notify the Marin County Building and Safety Division immediately of any additions, deletions, or changes to any of the information I have provided on this form.

Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors’ State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers’ compensation insurance coverage.

I hereby affirm under penalty of perjury that I am exempt from the Contractors’ State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors’ State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)):

By my signature at the end of this form, I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Website: www.leginfo.legislature.ca.gov

WARNING:  FAILURE TO SECURE WORKERS’ COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY’S FEES.

I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).

By my signature below, as the individual in whose name this(these) permit(s) shall be issued, I hereby affirm and certify each of the following, as well as all acknowledgements and agreements contained above, in this Request for Issuance Form:

My electronic signature agreeing to the afore mentioned is below:

A confirmation email will be sent with the information provided after you submit your form.