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CITY OF EL CERRITO PARKING PERMIT APPLICATION 10890 San Pablo Avenue, El Cerrito, CA 94530 Please send a copy of your current vehicle registration that reflects the applicable El Cerrito address. If your address is different than the one reflected on your registration, please submit a copy of a utility bill or other form of proof of residency to support your qualification for issuance of a permit. Please send the completed application, registration copy and proof of residency (if applicable) along with a check made payable to the “City of El Cerrito”. Your new permit will be sent to you in the mail. See www.el-cerrito.org/parkingpermit for more information on parking permits. (See Bottom of Back Sheet for Amounts) Vehicle #1 Resident Information Registered Owner: Street Address: Work Phone# Home Phone# Vehicle Description (Year) (Model) License Plate#: Vehicle ID Number (VIN): “I hereby certify that I live at the above address in the City of El Cerrito and the vehicle for which this permit is requested is housed at this same address.” Signature Date Vehicle #2 Resident Information Registered Owner: Street Address: Work Phone# Home Phone# Vehicle Description (Year) (Model) License Plate#: Vehicle ID Number (VIN): “I hereby certify that I live at the above address in the City of El Cerrito and the vehicle for which this permit is requested is housed at this same address.” Signature Date ---PAGE BREAK--- Maximum Vehicles per Residence is Four. (See Back For Additional Space) Vehicle #3 Resident Information Registered Owner: Street Address: Work Phone# Home Phone# Vehicle Description (Year) (Model) License Plate#: Vehicle ID Number (VIN): “I hereby certify that I live at the above address in the City of El Cerrito and the vehicle for which this permit is requested is housed at this same address.” Signature Date Vehicle #4 Resident Information Registered Owner: Street Address: Work Phone# Home Phone# Vehicle Description (Year) (Model) License Plate#: Vehicle ID Number (VIN): “I hereby certify that I live at the above address in the City of El Cerrito and the vehicle for which this permit is requested is housed at this same address.” Signature Date USE Permit Vehicle #1 Number: Permit Vehicle #2 Number: Permit Vehicle #3 Number: Permit Vehicle #4 Number: Receipt # Date Verified By West El Cerrito: 09/30/2012– 09/30/2015 $18.00 3 yrs. Per Vehicle (Orange Permit) Del Norte 09/30/2012 – 09/30/2014 Prorated $12.00 2 yrs. Per Vehicle (Blue Permit) El Cerrito Plaza: 09/30/2012– 09/30/2013 Prorated $6.00 1yr. Per Vehicle (Red Permit)