Yes No

Bakery Fish Grocery Meat Produce Super Market

Renewed Not Renewed Dissolution

Renewal New

Casual Dining Ethnic Family Fast Casual Fast Food Fine Dining

10 - Vacation Rental 11 - Agriculture; Forestry; Fishing and Hunting 12 - Food Services 21 - Mining 22 - Utilities 23 - Construction 31-33 - Manufacturing 42 - Wholesale Trade 44-45 - Retail Trade 48-49 - Transportation and Warehousing 51 - Information 52 - Finance and Insurance 53 - Real Estate Rental and Leasing 54 - Professional; Scientific; and Technical Services 55 - Management of Companies and Enterprises 56 - Administrative and Support and Waste Management and Remediation Services 61 - Educational Services 62 - Health Care and Social Assistance 71 - Arts; Entertainment; and Recreation 72 - Accommodations 81 - Other Services (except Public Administration) 92 - Public Administration

Yes No

Yes No

AL AK AZ AR CA CO CT DE FL HI ID IL IA KS KY ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS DC FM GU MH MP PW PR VI

Last Name

Phone #

Name

ZIP

Address

Food Truck License Plate #

Email

Block

By signing, I attest that the information contained herein is true and correct to the best of my knowledge and belief. I further testify my business is in compliance with all local, state, and federal laws, and may be reviewed by jurisdictions at the city, county, state, or government level. I understand this license cannot be transferred to a new owner or location without first notifying the county. If the information listed on this application changes in any way, I agree to immediately notify the county of such change. I further understand that, after this initial application, should I receive a business license, that license must be renewed on or before July 1 of every year. I understand I need to allow two weeks for processing an application.

Please attach any necessary documents

Business Details

Mailing Address

Registration Type

Type	Fee
New License	January 1 thru June 30 - $63 July 1 thru December 31- $125
Annual Renewal	$125
Application Fee	$0.00

Mailing Address

Restaurant Type (If Applicable)

Mailing City, State, ZIP

Are you registered in the State of Oregon?

Phone #

Business Launch Date

Would you like to register for TLT (Transient Lodging Tax)?

Business Name (DBA)

Max Number of Guests Allowed?

Industry Category (If Other)

Lot

Emergency Contact Details

Building Owner/Property Management Details

Food Truck Model

State

Federal ID #

Phone #

Fee Schedule

Last Name

City

Industry Category

First Name

Application Fee

Food Truck Make

Phone #

Physical Address

Certification

Attachments

Applicant Signature

Business Owner Details

State Registration #/ Holding Company

When you are finished, press the submit button below to be routed to the payment portal.

Mailing City, State, ZIP

Business License Application

Product or Service Provided

First Name

City

Hazards and other relevant information

Email

ZIP

Business Website/Facebook URL

Address where the business exists. If address is not available, select 'Non Resident or Address not Found'. *