Residential Rental Permit

RESIDENTIAL RENTAL PERMIT

Application Date:    Permit/Application No.:

Property Identification

Unit/Suite:    APN / Parcel Number:    Year Built:

Owner / Applicant Information

Phone:    Email:

Manager Phone:    Manager Email:

Unit / Tenancy Details

Unit Type: Single-family Duplex Multi-family / Apartment

Number of Units on Property:    Unit Identifier (if applicable):    Bedrooms:    Bathrooms:

Current Occupancy (number of tenants):    Lease Start Date:    Lease End Date:

Monthly Rent:    Security Deposit:    Rent Due Date (day of month):

Safety, Health and Code Compliance

Smoke Detectors Installed and Functional: Yes No

Carbon Monoxide Detectors Installed: Yes No

Emergency Egress and Exit Windows Present: Yes No

Known Lead-Based Paint (pre-1978 construction): Yes No

Evidence of Mold or Water Intrusion: Yes No

Inspection and Permit Conditions

Applicant agrees to allow all necessary inspections by code enforcement and to complete any required corrective work within the timeframes established by the issuing authority. Failure to permit inspection or comply with required corrections may result in permit denial, suspension, revocation, or administrative penalties.

Late Reinspection Fee:    Reinstatement Fee for Revoked Permit:

Disclosures and Legal Certifications

Prior Code Violations on Property: Yes No

Applicant Certification:

By signing below, the Applicant certifies under penalty of law that the information contained in this application is true and correct to the best of the Applicant's knowledge. Applicant acknowledges that submission of false or misleading information is grounds for denial or revocation of the permit and may subject the Applicant to civil or criminal penalties. Applicant further certifies that all rental units will be maintained in compliance with applicable housing, health and safety codes and agrees to allow lawful inspections.

Insurance and Liability

Applicant is advised to maintain commercial general liability insurance and any other insurance as required by lease agreements. Issuance of this permit does not create liability on the part of the issuing authority for the condition or maintenance of the property. Applicant agrees to indemnify, defend and hold harmless the issuing authority, its officers and employees from any claims arising out of the Applicant's ownership or operation of the rental property.

Default, Revocation and Remedies

The issuing authority may suspend, revoke, or refuse renewal of the permit for failure to comply with applicable codes, failure to pay required fees, misrepresentation on this application, or failure to complete required corrective actions. Administrative enforcement remedies, civil fines, and abatement actions may be pursued in addition to permit revocation.

Governing Law and Miscellaneous

This Permit Application and any issued permit shall be governed by the laws and municipal code of the jurisdiction in which the property is located. If any provision of this application or permit is judged invalid by a court of competent jurisdiction, the remaining provisions shall remain effective. This application, when accepted and a permit issued, together with any referenced attachments or correction orders, constitutes the entire agreement regarding the authorization to operate the rental unit and supersedes prior oral or written statements.

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