Multi-Family Rental Registration Application

Multi-Family Rental Registration Application

Annual Application required for all new and renewal licenses due January 30 Updated application due within 15 days of ownership or management change.
Multi-Family Rental Registration Application
License Application

Ownership ChangeManagement ChangeAnnual Renewal
Select One

Apartment4-PlexSenior Living (Excludes Assisted Living)
Property Name
CO/TCO Date*

MonthDayYear
Date
Address

Address

Street Address Line 2

CityState / Province

Zip
Phone
Email
example@example.com
Access Gate Code: (if applicable)
Emergency 24/7 Phone
*If not known, contact city staff
Unit Count / Mix
No. of Buildings with Dwelling Units
No. of Accessory Buildings
(Garage, Carport, Maintenance Buildings, etc.)
1. Number of Efficiency Units
2. Number of One Bed Units
3. Number of Two Bed Units
4. Number of Three Bed Units
5. Number of Four Bed Units
6. Number of Washaterias
7. Number of Gyms/Rec Centers
8. Number of Gyms/Rec Centers
Current Occupancy %
Total Unit Count (# 1-8)
GENERAL INFORMATION
Owner Name
Address

Address

Street Address Line 2

CityState

Zip
Phone Number
Please enter a valid phone number.
Email
example@example.com
Property Management Company
Address

Address

Street Address Line 2

CityState

Zip
Phone
Email
example@example.com
Property Manager
Address

Address

Street Address Line 2

CityState

Zip
Phone
Email
example@example.com
MULTI-FAMILY RENTAL REGISTRATION APPLICATION
INSURANCE COMPANY
Insurance Company
Contact Name
Address

Address

Street Address Line 2

CityState

Zip
Phone
Email
example@example.com
ACCOUNTS PAYABLE
Person Responsible for Payment of Utility Bill
Address

Address

Street Address Line 2

CityState

Zip
Phone
Email
example@example.com
I hereby certify that all information submitted with this application is true to the best of my knowledge.
Signature of Owner, Agent, Manager or Representative

Clear
Printed Name
Title
Date

MonthDayYear
Date
Per Chapter 3, Melissa Building and Construction, Section 3.1500 Multi-Family Rental Property Registration and Inspection, all information shall be provided. Ordinance available at [insert link to ordinance]
Should be Empty:

Multi-Family Rental Registration Application

Multi-Family Rental Registration Application

Unit Count / Mix

GENERAL INFORMATION

MULTI-FAMILY RENTAL REGISTRATION APPLICATION

INSURANCE COMPANY

ACCOUNTS PAYABLE