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RESIDENTIAL PARKING PERMIT FY 2019/2020 APPLICATION FORM Updated 10/1/19 Finance Department 10890 San Pablo Avenue El Cerrito, CA 94530 [EMAIL REDACTED] (510) 215-4335 INSTRUCTIONS: With this application form, please submit a valid copy of your car registration that reflects the applicable El Cerrito address. If the address is different than the one reflected on your car registration, also include a copy of a utility bill or rental lease to confirm your residency at the address. Send the completed application, registration copy, and proof of residency (if applicable) along with a check made payable to City of El Cerrito. Please check the district table below to confirm amount due. If you are unsure what district you reside in, please call the City to confirm. *Please note that parking permits are non-renewable. As such, a copy of your car registration and proof of residency (if applicable) must be submitted each time you purchase a new permit. STREET ADDRESS: VEHICLE #1 PERMIT # (OFFICE USE ONLY) Resident Information Registered Owner: Home Phone: Work Phone: Vehicle Description Year: Make: Model: License Plate VIN: Reminder to renew? E-mail: “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.” Initial Date VEHICLE #2 PERMIT # (OFFICE USE ONLY) Resident Information Registered Owner: Home Phone: Work Phone: Vehicle Description Year: Make: Model: License Plate VIN: Reminder to renew? E-mail: “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.” Initial Date OFFICE USE ONLY VEHICLE #3 PERMIT # (OFFICE USE ONLY) □ Del Norte Resident Information Blue Permit Registered Owner: 10/01/2019-09/30/2020 Home Phone: Work Phone: $7.00 each permit [1 yr.] Vehicle Description Year: Make: Model: □ West El Cerrito License Plate VIN: Orange Permit Reminder to renew? E-mail: 10/01/2019-09/30/2021 “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.” Initial Date $14 each permit [2 yrs.] VEHICLE #4 PERMIT # (OFFICE USE ONLY) □ El Cerrito Plaza Resident Information Red Permit Registered Owner: 10/01/2019-09/30/2022 Home Phone: Work Phone: $21.00 each permit [3 yrs.] Vehicle Description Year: Make: Model: ACCOUNT License Plate VIN: DATE: Reminder to renew? E-mail: VERIFIED BY: “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.” Initial Date TOTAL DUE: $