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<br />Page 5 of 6 <br /> 5/5/2026 <br /> (Building permit number) (Final inspection date) <br /> <br /> <br /> <br />OR <br /> <br />b. ☐ If work did not require a building permit, a copy of a signed letter from a licensed <br />contractor certifying that the substantial remodel is complete (Include with this form) <br /> <br />4. Verified Substantial Remodel Costs: <br /> <br />The substantial remodel costs plus any relocation assistance payments (excluding security <br />deposit) provided to the tenant under the City’s Tenant Protection Ordinance. <br /> <br />a. Substantial remodel costs must be verified through receipts and proof of payment. <br /> <br />b. Costs incurred prior to the vacancy of the rental unit will not be considered. <br /> <br />c. Any costs reimbursed by insurance or some other subsidy will be excluded from the <br />Verified Substantial Remodel Costs. <br /> <br />d. Building or property-wide improvement costs will be distributed proportionately across <br />all units in the building/property when determining the Verified Substantial Remodel <br />Costs applicable to a particular rental unit. <br /> <br />e. Relocation assistance payments must be verified through proof of payment. <br /> <br />f. Any forgone income during the substantial remodel is not included in the Verified <br />Substantial Remodel Costs calculation. <br /> <br />5. Verified Substantial Remodel Costs per unit <br /> <br />a. Total amount of substantial remodel cost for the unit: ______________ <br /> <br />b. Amount of relocation assistance paid for the unit: ______________ <br /> <br />c. Subtract any subsidies or insurance reimbursements received for the unit: <br />____________ <br /> <br />d. Total Verified Substantial Remodel Cost for the unit: ______________ <br /> <br /> Required Documentation: Itemized list of substantial remodel costs with invoices (including <br />proof of payment) or receipts for each item. For building and/or property-wide improvements, <br />please include calculations for how those costs were proportionally distributed to each unit. <br />Proof of payment must be included for each item. Acceptable proof of payment includes: <br />a. Receipt for materials <br />b. A signed receipt from a contractor <br />i. Must include the contractor’s name, amount paid, date of payment, and a brief <br />description of the work. <br />c. A cancelled check showing it was deposited <br />If the substantial remodel required multiple building permits, please <br />attach a separate sheet listing all building permit numbers and the final <br />inspection date for each permit <br />8.A. - Page 66 of 85 <br />324