Rental Housing Inspection Program Application For Exemption printable pdf download

CITY OF SACRAMENTO

RENTAL HOUSING INSPECTION PROGRAM

APPLICATION FOR EXEMPTION

MAILING ADDRESS: 915 I Street, MC 20000

Sacramento, CA 95814

Ph (916) 808-7368 Fax (916) 288-9955

To request that your property be exempt from the Rental Housing Inspection Program, fill in the property information,

indicate the reason for exemption by checking the appropriate box below and sign and date the following declaration:

DECLARATION

I, _____________________________________ hereby declare the following:

I am the owner of the property located at __________________________, Assessor’s Parcel Number ______-________-______-______

Sacramento, California (“Property”).

I understand and acknowledge that pursuant to Article II of Chapter 8.120 of the Sacramento City Code all rental housing properties and rental

housing units are subject to routine periodic inspection by the City of Sacramento.

I believe that the unit(s) identified as ________________________ [address, unit number or other identifier] on this Property is/are exempt for the

following reason(s): (Please check all reasons that apply)

The unit(s) is newly constructed and has passed final inspection by the City of Sacramento

within the last five (5) years.

The unit(s) is subject to routine interior and exterior periodic inspection by another

government agency as listed below:

Agency Name: _________________________________________

(Please attach documentation such as copy of last payment voucher or Section 8 agreement.

Documentation must be current and must show the rental property address. )

The unit(s) is not a “rental housing unit” as defined by section 8.120.030 of the Sacramento

City Code.** (please explain):

____________________________________________________

I (we) no longer own this property as of:

______________________________________________________

I understand that if I engage in the business of rental housing with any non-exempt rental housing units, I am required to register the property with the

City of Sacramento and pay any and all related fees as required by the Rental Housing Inspection Program.

SIGNATURE OF OWNER:

OWNER’S ADDRESS:

_____________________________________________________

PRINTED NAME OF OWNER:

DATE:

_____________________________________________________

__________________________________________

DAYTIME PHONE NUMBER:_________________________________

**“Rental housing unit” means a single unit of residence for a single housekeeping unit of one or more persons, that is being rented, or is intended to be rented.

Examples of housing units covered by this chapter include apartment units, condominiums, duplexes and single-family houses. “Rental housing unit” also includes

other types of residential units that provide for sleeping accommodations but toileting or cooking facilities are shared by occupants of more than one unit, such as

residential or single room occupancy hotels. This does not include units used for transient lodging such as dormitories, group homes, rooming or boarding houses,

hotels, motels, and bed and breakfast inns. (Ord. 2008-012 § 1)

Rev 05/29/2015

Rental Housing Inspection Program Application For Exemption

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