Fill - Free fillable Sh Owners Affidavit (Port of Richmond) PDF form

ort-Term Rental Permit:

Owner’s Affidavit

Please read and initial your understanding of each condition

_______ Only a short-term rental operator shall operate the short-term rental.

_______ The short-term rental operator shall reside on the premises 185 days per year

_______ A maximum of five (5) sleeping rooms are permitted.

_______ A maximum of two (2) persons over the age of 18 shall occupy each sleeping

room.

NOTE:

The Virginia Uniform Statewide Building Code (VUSBC) may reduce

occupancy.

_______ At least one person in the short-term renter party shall be 18 years of age or

older.

_______ No short-term rental may have more than one booking transaction for the same

date.

_______ The Short-Term Rental Permit Number shall be displayed on all advertisements.

_______ No short-term rental operator shall offer, allow, provide, or advertise a short-term

rental for any commercial use not customarily incidental, including, but not limited

to, the use for parties, banquets, weddings, meetings, filming, advertising activities,

or any gathering of persons other than the authorized short-term renter.

FLOOR PLAN REQUIREMENTS

(MUST BE DRAWN TO SCALE OR PROVIDE DIMENSIONS)

(INITIAL BY EACH)

_______ Use of each room

_______ Occupancy level of sleeping room(s)

_______ Location and dimension(s) of door(s) and/or window(s)

_______ Location of Carbon Monoxide Detector(s)

_______ Location of Fire Extinguisher(s)

_______ Location of smoke detector(s)

TO BE COMPLETED BY THE APPLICANT

SHORT-TERM RENTAL OPERATOR NAME:

PRIMARY RESIDENCY ADDRESS:

SHORT-TERM RENTAL OPERATOR EMAIL ADDRESS:

SHORT-TERM RENTAL OPERATOR PHONE NUMBER:

Short-Term

Rental Agreement:

THIS AGREEMENT, entered into this ___________ day of, ______________, 20 , by and

between The Zoning Administration Office of the City of Richmond and

_________________________ (owner), who is responsible for and controls the real property

located at _____________________________________ (Tax Map: _________________ ), in the

City of Richmond, Virginia, hereinafter referred to as, ”Responsible Party”.

W I T N E S S E T H :

• The “Responsible Party” understands, agrees and stipulates that the conditions set forth

will be met. This waiver is voluntarily and freely made with the full knowledge of its

effect and consequences.

• The “Responsible Party” also consents and agrees that the Zoning Administrator or his

duly authorized agent(s) may enter the property, on reasonable notice to the

“Responsible party”, for the purposes of determining compliance with the subject Short-

Term Rental Permit and take such action as may be necessary to bring about complete

conformance with all terms and conditions of this agreement.

• This Agreement shall be interpreted in accordance with laws of the State of Virginia.

• This is a fully integrated Agreement and contains the entire Agreement between the

parties. Any prior written or oral Agreements that are different in terms, conditions and

provisions of this Agreement shall be of no effect and shall not be binding upon either

party unless referred to herein.

• No amendment or modification at this Agreement shall be valid unless expressed in

writing and executed by the parties hereto in the same manner as the execution of this

Agreement.

BY: ___________________________________________

(Print Name)

OWNER: ___________________________________________

(Signature)

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signature

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Short-Term Rental Permit:

Primary Residency Documentation

Primary Residency Requirement

Ordinance No. 2019-343 requires that a short-term rental shall be on the lot of the

operator’s primary residence with the operator occupying the lot at least 185 days

each year.

To provide verification of primary residency at the property, please provide:

• Two (2) documents from the primary list; and,

• Two (2) documents from the primary or secondary list

Original documents must show your name and the address of your current

residence as it appears on the application.

Primary Proof of Residency Documents

• Virginia current driver or commercial driver license displaying the current

address

• DMV-issued ID card displaying the current address

• Employer payroll check stub issued within the last two months

• Social security statement for the current calendar year

• Internal Revenue Service W-2 tax form not more than 12 months old

Secondary Proof of Residency Documents

• Virginia voter registration card mailed to you by your local registrar

• Current automobile insurance bill (cards or policies are not accepted)

• Certified copy of school records/transcript or official report card issued within the last

year (online courses not accepted)

• Monthly bank or credit card statement not more than two months old

• Receipt for personal property taxes paid within the last year to the Commonwealth of

Virginia or a Virginia locality

• Medical or dental bill issued within the last two months

• Official correspondence from a governmental agency displaying the applicant’s name

Fill Online, Printable, Fillable, Blank Sh Owners Affidavit (Port of Richmond) Form

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Fillable Sh Owners Affidavit (Port of Richmond)

Fill Online, Printable, Fillable, Blank Sh Owners Affidavit (Port of Richmond) Form

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