Form DS-20 "Request for Residential High Occupancy Permit" - City of San Diego, California

What Is Form DS-20?

This is a legal form that was released by the California Department of Developmental Services - a government authority operating within California. The form may be used strictly within City of San Diego. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2008;
  • The latest edition provided by the California Department of Developmental Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DS-20 by clicking the link below or browse more documents and templates provided by the California Department of Developmental Services.

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Download Form DS-20 "Request for Residential High Occupancy Permit" - City of San Diego, California

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fORM
City of San Diego
Request for Residential
Development Services
DS-20
1222 First Ave., MS-302
High Occupancy Permit
San Diego, CA 92101
(619) 446-5000
F
2008
ebruary
Project No.
This form is required for a single dwelling unit with six or more persons eighteen years of age and older residing for 30 or
more consecutive days in accordance with Section 123.0502.
Please print legibly or type.
1. Site Address
Zip Code
Assessor’s Parcel No.
2. Applicant Name
Address
City
State
Zip Code
Telephone
List all property owners with ownership in the subject property
3. Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
4. Local Contact/Responsible Party Information:
Address
City
State
Zip Code
Telephone
List all occupants eighteen years of age and older that reside on the premises for 30 or more consecutive days and list the associ-
ated registered vehicles. Please attach lease agreement (Rental properties only)
5. Tenants
Drivers License Number
Vehicle License Plate Number
Printed on recycled paper. Visit our web site at
www.sandiego.gov/development-services.
Upon request, this information is available in alternative formats for persons with disabilities.
DS-20 (02-08)
fORM
City of San Diego
Request for Residential
Development Services
DS-20
1222 First Ave., MS-302
High Occupancy Permit
San Diego, CA 92101
(619) 446-5000
F
2008
ebruary
Project No.
This form is required for a single dwelling unit with six or more persons eighteen years of age and older residing for 30 or
more consecutive days in accordance with Section 123.0502.
Please print legibly or type.
1. Site Address
Zip Code
Assessor’s Parcel No.
2. Applicant Name
Address
City
State
Zip Code
Telephone
List all property owners with ownership in the subject property
3. Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
Property Owner Name:
Address
City
State
Zip Code
Telephone
4. Local Contact/Responsible Party Information:
Address
City
State
Zip Code
Telephone
List all occupants eighteen years of age and older that reside on the premises for 30 or more consecutive days and list the associ-
ated registered vehicles. Please attach lease agreement (Rental properties only)
5. Tenants
Drivers License Number
Vehicle License Plate Number
Printed on recycled paper. Visit our web site at
www.sandiego.gov/development-services.
Upon request, this information is available in alternative formats for persons with disabilities.
DS-20 (02-08)
Page 2 of 2
City of San Diego • Development Services Department
Request for Residential High Occupancy Permit
6. Required drawings: Plot Plan and Vicinity Map
For more information, refer to Information Bulletin 122 “How to Prepare a Single Dwelling Unit Plot Plan and Vicinity Map”
7. Parking requirement
The applicant shall demonstrate on submitted plans that one off-street parking space per occupant eighteen years of age and
older, less one will be accommodated on the premises in accordance with Section 123.0504.
yes
no
Parking Reduction Requested
Please attach any documents that you feel are necessary to support your request for a lesser parking requirement.
Owner Declaration: I ___________________________, certify, under penalty of perjury under the laws of the State of California,
that there are ___________ occupants eighteen years of age and older residing on the premises and that there are ___________
vehicles associated with the premises.
Signature
_________________________________________
Date __________________________________
8. Fee waiver for economic hardship
yes
no
Fee Waiver Requested
If yes, please attach income tax forms for each property owner to demonstrate that total annual income is less than the Area Median Income for
the San Diego Standard Metropoltian Statistical Area as published by the United States Department of Housing and Urban Development.
9. Code compliance
yes
no
Pending violation case related to residential high occupancy
Other pending violation case at this property ____________________________________________________
10. Owner Declaration: I ____________________________, certify, under penalty of perjury under the laws of the State of Cali-
fornia, that the information provided above is correct. Willfully providing false statements or failing to report a material fact on
this application is a violation of SDMC Section 11.0401 (b) and may be prosecuted civilly or criminally as a misdemeanor.
Signature
_________________________________________
Date __________________________________
FOR CITY USE ONLY
yes
no
Lease agreement provided
Parking reduction granted
Fee waiver granted
Documentation provided to support parking and/or fee waiver request:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Name: ________________________________________________________
Staff Title: ________________________________
Signature: ____________________________________________________
Date: _____________________________________
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