Type Full Name :
Sign With Hand
• Application Fee: $75 (Fee is Non-Refundable, even if application is Denied)
• Initial Inspection Fee: $55
• Reinspection Fee: $35 (If initial inspection fails)
City, State, ZIP
# Bedrooms *
Stockholder Details
# On Site Parking Spaces *
Fee Schedule
{[CITY]}, {[STATE]} {[ZIP]}
Click here to review Ordinance No. 5621 for the rules governing Short Term Rentals.
If Owner is a Corporation or other legal entity, list stockholders and percentage
Property Owner Details
Type *
Signature *
Is this your principal place of dwelling? *
I understand that if granted a Permit for this Short-Term Rental (STR) Property, the Permit is NON-TRANSFERRABLE, and Permit may not be assigned to any other location.

By signing below, I certify that the foregoing statements made by me in this application are true. I am aware that if the foregoing statements made by me are willfully false, this application will be invalidated; I will lose my rights to obtain a Short-Term Rental License, and I am subject to punishment under law.

# On Street Parking Spaces Adjacent to Premises *
Important Information
Business Type
Contact Person Details
Address *
Ordinance No. 5621
Building Type
Email *
Begin typing address and select from the populated dropdown *
The person listed must be available 24 hours a day, 7 days a week for the purpose of responding within one (1) hour of any complaints
City, State, ZIP
How would you like to make payment? *
Phone #
Property Details
Who should we contact for inspections? *
Required Attachments
Name *
Address *
• Valid Certificate of Occupancy
• Green Card if a Multiple Dwelling
• Proof taxes are paid up to date
• Proof water is paid up to date
• Proof of Home Insurance (Short-term rental activity must be attached)
• If the property is a condominium, a letter of Approval from the Condominium Association must be attached
• Owner’s Driver License
• Manager’s Driver License (if applicable)
• Health Department Certificate
• Completed Property Search
• Proof of General Liability Insurance (Minimum of $500,000)
Agent Details
Unit #
City, State, ZIP *
• If any code violations were issued by the City with regards to the rental property, no short-term rental Certificate will be issued until all violations on property are abated.
• We will NOT issue Temporary or Conditional Certificates. All inspections will be a pass or fail. If you need a re-inspection it will be $35.
• No Short-Term Rental property shall be rented to anyone younger than 21 years old.
• Short-Term Rental transient occupants shall comply with all ordinances of the City of Elizabeth including those regulating noise and nuisance conduct
Phone # *
Phone #
Occupant Details
City of