Type Full Name :
Sign With Hand
Last Name
Business Phone #
Name
I, the applicant, hereby certify that the information supplied herein is true and correct. I further certify that the business for which this application is being submitted complies with all applicable statues and regulations and all applicable ordinances. I understand that violation of any applicable statute, regulation, or ordinance may be grounds for revocation of the Business License for which this application is submitted. I further understand that if any information I have provided in this application is willfully false or misleading, I may be subject to denial of this application or revocation of the License for which this application is submitted.
Address
Email
Block
State ID #
Please attach the following documents:
1) Copy of your State License.
2) Certificate of Liability Insurance.
3) Survey and floor plan, or sketch showing the property line.
4) Floor plan of the interior of the building premises where business is to be conducted.
Business Location
Registration Type
Address
Address 2
Add any additional business owners by clicking on the "Add Additional Owners" button below:
City, State, ZIP
Ownership Type
Address
Phone #
Business Name
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Business Information
Name
Lot
Emergency Contact
Building Owner
Relationship to Business Owner
State
Federal ID #
Phone #
Occupancy Load
Last Name
Is it a non-profit organization?
Phone #
Business Category
First Name
Phone #
Address
Certification
Attachments
Applicant Signature
Business Owner
# of Employees
Business Description (Describe the nature of the Business, including types of products to be sold, services provided, or activities conducted) If your business is closing, please indicate in the Business Description below with the anticipated date of closure.
First Name
City
Alarm Company
Days and Hours of Operation
Business Email
Square Feet
Website URL
Email
ZIP
{[PNAME]}
Search for the business address and select it from the drop-down.