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2. City of Rohnert Park

   Residential Parking Permit Application

4. Permit Type*

   1. New
   2. Renewal
   3. Temporary
5. First and Last Name*
6. Phone Number*
8. Address*
10. City*
11. State*
12. Zip Code*
14. California Drivers License Number*
15. Landlord Name
16. Landlord Phone Number
20. Vehicle #1 License Plate Number*
21. Vehicle #1 Year*
22. Vehicle #1 Make*
23. Vehicle #1 Color*
25. Attach DMV Vehicle Registration*

    Attach valid California DMV vehicle registration for vehicle #1. 

    A copy of the current registration for each motor vehicle needing a permit, maximum of three permits is allowed. (If the registered owner is different from the resident, a letter is needed from the registered owner stating that you, the resident, have been authorized sole use of the motor vehicle.)

29. Vehicle #2 License Plate Number
30. Vehicle #2 Year
31. Vehicle #2 Make
32. Vehicle # 2 Color
34. Attach DMV Vehicle Registration

    Attach valid California DMV vehicle registration for vehicle #2. 

    A copy of the current registration for each motor vehicle needing a permit, maximum of three permits is allowed. (If the registered owner is different from the resident, a letter is needed from the registered owner stating that you, the resident, have been authorized sole use of the motor vehicle.)

38. Vehicle #3 License Plate Number
39. Vehicle #3 Year
40. Vehicle #3 Make
41. Vehicle #3 Color
43. Attach DMV Vehicle Registration

    Attach valid California DMV vehicle registration for vehicle #3. 

    A copy of the current registration for each motor vehicle needing a permit, maximum of three permits is allowed. (If the registered owner is different from the resident, a letter is needed from the registered owner stating that you, the resident, have been authorized sole use of the motor vehicle.)

47. By my signature on this Application for a Residential Parking Permit, I acknowledge that I reside at the address stated hereon, and I am the authorized owner or lessee using the motor vehicle(s) bearing the license plate number(s) on this application. I further acknowledge that the current California DMV Registration(s) must be presented with this application and each year thereafter for renewal of permit(s). “Motor vehicle” is defined as an automobile, truck, motorcycle, or other motor driven form of transportation not in excess of 8,000 pounds gross vehicle weight (Vehicle Code Section 22507).

    I UNDERSTAND THAT THIS/THESE PERMIT(S) IS/ARE INTERCHANGED AMONG ALL MOTOR VEHICLE (WHICH IS/ARE CURRENTLY REGISTERED WITH DMV) ASSOCIATED WITH EACH RESIDENCE OR PERSON LISTED ON THE APPLICATION AND SHALL BE DISPLAYED PER THE INSTRUCTIONS RECEIVED WHEN PURCHASING THE PERMIT. I FURTHER UNDERSTAND THAT I am not guaranteed a parking space on the public street in front of my residence and/or neighborhood and that the parking privilege on the street is subject to a first come, first served basis subject to space available. The residential neighborhood in which I am approved to park is indicated by the color and label on my permit. I may park only on the streets where the signs are posted.

    The Temporary Parking Permit exempts me from the posted time limit within the boundaries of my approved residential neighborhood only.

    I declare that I have read and understand the “Residential Parking Application and Residence Declaration Ordinance 818,” and the “Residential Permit Instructions” and that I have possession of the above licensed motor vehicle(s). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

49. Applicant Signature*

    Type First and Last Name

50. Date*
    Date
52. Attach Proof of Residence*

    Provide ONE of the following:

    • Copy of lease/rental agreement, or
    • Letter from owner of property verifying your residence, or
    • Copy of a current PG&E bill, Utility bill, or resident phone bill addressed to you at address for which the permit is being requested, or
    • Title/Escrow papers
53. Attach Copy of Drivers License*

    Attach a copy of your valid California Driver's License

54. Letter from Registered Owner

    If needed, attach a copy of the letter from the registered owner providing permission to drive the vehicle.

58. Request for Exemption of the Vehicle Ownership Requirement

    I declare that I am the resident of the above listed address, and although I do not own a motor vehicle, I have need for a parking permit.

60. Check All that Apply*

    1. Family
    2. Friends
    3. Caretakers
    4. Service Providers
    5. Other
61. Signature *

    Print First and Last Name

62. Date*
    Date
64. If other was checked, Please specify.
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71. Print Only

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