Application to license a house in multiple occupation from Derby City Council

Step 2 of 4 Submit the application

Email address

Please provide your email address, so the licensing authority can let you know if your application has been successful or not.

Email address Confirm email address

Application form

Please attach the completed application form below.

Application form

Supporting documents

All documents are required, unless stated otherwise. Photos of documents are acceptable, as long as all the relevant information is clear. We'll only share these documents with the licensing authority.

Maximum size allowed per file is 10 MB.

We only allow the following file types : doc, docx, gif, jpeg, jpg, pdf, png, ppt, pptx, rtf, txt, xls, xlsx

What if I can't submit all of these documents?

You don't have to submit optional documents, but it may improve your chances of a successful application if you do.

Property Plan
Provide a detailed plan, preferably to scale, of every floor of the property. Each room's use must marked on the plan and please give bedroom and kitchen/dining/living space dimensions, and the position and number of kitchen and bathroom facilities. All fire precautions including the fire detection and alarm system, emergency lighting (where installed) and fire escape windows should be identified.

Landlords Gas Safety Certificate
Provide a current Landlord's Gas Safety Certificate, signed by an appropriately qualified Gas Safe Registered engineer.

Electrical Installation Condition Report (EICR)
Provide a current Electrical Installation Condition Report, undertaken by an appropriately qualified and competent electrcial contractor.

Photo identification and proof of residential address
Provide photo identification and proof of residential address for each person that has an interest in the property. If the property is owned by a company we require this for every director. A driving licence is the preferred method of identification but we will accept a passport and utility bill.

Fire Safety Risk Assessment (FSRA)
Provide a copy of the current FSRA for the property.

Fire Alarm Certificate (optional)
Provide a copy of the current Fire Alarm inspection and test certificate (if applicable).

Emergency Lighting (optional)
Provide a copy of the current Emergency Lighting inspection and test certificate (if applicable).

Portable Appliance Testing (optional)
Provide a copy of the current PAT testing certificate for all applicable portable electrical appliances provided as part of the let.

Declaration

I/we declare that the information in this application is correct to the best of my/our knowledge. I/we understand that I/we commit an offence if I/we supply any information to the local housing authority in connection with any of their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I/we know is false or misleading or am/are reckless as to whether is false or misleading. I/we declare that I/we have served a notice of this application on the persons detailed in Table 1 of this application, who are the only persons known to me/us that are required to be informed that I/we have made this application.

Ticking this box indicates you have read and understood the above declaration

By continuing, you're giving the Cabinet Office permission to pass the information you're supplying to the relevant authority.

For more details on how your information is used please refer to the Government Digital Service privacy notice (opens in new tab) and Derby City Council.