Type Full Name :
Sign With Hand
City, State, ZIP
# of Bedrooms
I have read and acknowledge the Smoke Detector and Carbon Monoxide Requirements.
New Occupant(s)
Resale Certificate $175 ($100 for the Housing Resale Certificate of Inspection & $75 for the Fire Certificate)
Rental Certificate $350 per unit.
Lead Safe Certificate $150 + State fee of $20 per unit.
Phone #
Current Property Owner Information
Application Type
Property Type
Signature
By signing below, I the owner certify that all of the information provided in this application is true and accurate. I certify that this dwelling and all other structures on the property meet the zoning requirements of the {[CNAME]} I attest to the fact that no rubbish/debris/bulk garbage will be left on this property prior to new occupancy. I understand that failure to comply will result in retraction of the {[PNAME]} and a summons will be issued. I understand that this applies to all properties that fall within the {[CNAME]}.
Attachments
Fees
# of Units
Year Built
Contact for Inspections
Address
Applicant/Agent same as owner?
Occupation Status
City, State, ZIP
Email
Name
Address
Buyer Information
Lot
I have read and acknowledge the Housing Resale and Fire Certificate Information.
Email
Block
Type and select the address of the property
(Rentals)
Date Lease End
Name
Address
Name
Email
Application Information
Company Name
(Sales)
Date of Closing
Phone #
Property Information
I acknowledge all open permits must be closed prior to a certificate being issued.
Who should we contact for inspections?
Certification
Is the inspection going to be done through a third party?
Name
Address
Rental/Resale Inspection
Application
Amount Due
Applicant/Agent Information
Address 2
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[PPHONE]}
{[AWEBSITE]}
Attach any necessary documentation below.
All owners of properties or units constructed prior to 1978 are required to submit a Lead Safe Certification.
City, State, ZIP
Phone #
Phone #
Email
Intention of Buyer