PW-Form No. 057 (
City of Riverside Permit Processing PO Box , CA
I declare that I understand and agree to the statement above and that the information provided on this application is true and correct under penalty of perjury under the laws of the State of California. Signature: ___________________________________ Date: _______________ Date: ________________________________ Applicant Name: ____________________________________________ Phone Number: ______________________ Riverside Address: ____________________________________________ E-mail Address: ______________________ Corner Property? Yes No If Yes, Block number & Cross Street Name: ____________________ Please Enclose the Application fee of $Make check payable to: City of Riverside. Please Note: ALL UNPAID PARKING CITATIONS MUST BE BROUGHT CURRENT PRIOR TO PERMIT ISSUANCE. List License Plate Numbers of Vehicles Registered at This Address: ALL VEHICLES LISTED MUST BE CURRENTLY REGISTERED AT APPLICANT’S ADDRESS (CVC 4159). Staff Use ONLY License Plate RegistrationExpiration Date Permit Number Permit Color Issue Date Revoke Date Preferential Parking Zone (PPZ) Permit Acknowledgement 1. Resident Permits are issued to a specific vehicle and are non-transferable between vehicles. Resident permits areissued to residents who have provided proof of residency including a current State of California vehicle registrationshowing residency within a Preferential Parking Zone (PPZ) within the City of Riverside.2. Guest Permits shall be used solely for visiting the resident to which the permit is registered and only for the duration ofthe visit.3. In order for the permit to be considered valid, the permit must be displayed in the vehicle as per the instructionsincluded on the permit.4. Use of a permit signifies the parked vehicle is not subject to the posted Preferential Parking Zone or PPZ restriction. Allother regulations continue to apply. For example, the Municipal Code prohibits storage of vehicles on the street formore than 72 consecutive hours, or parking during street sweeping hours.5.The permit does not provide a reservation of any parking space.
Preferential Parking Permit Application Please Check One: Initial Application Replacement SupplementalRelocation Staff Use ONLYDate Processed _________________Amount _______________________CA CC CK# ___________Initials ________________________Issued via: Mail InPerson ONLINE: Create an account to pay for your application at. Complete this form and mail it, along with payment, to the PO Box listed above. IN-PERSON:Visit 3900 Main Street, 4th Floor, Riverside CA 92522 to submit the application and payment in person. the Application fee of$