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Renewal
New
Single User
Multi-tenant
Yes
No
New Owner of Existing Business (owner change)
Balance Remaining
Subject of Property
Registration Type
*
Alteration or Renovation to Interior, Exterior or Site
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Application Type
*
Building Address
Please Select All That Apply:
Amount Due
New Business entity (entirely new business)
Is the Property Currently Occupied?
*
New Business Name (Name Change Only)
Non-Residential Occupancy Registration
Address
*
Owner Details
Business Details
Existing Use
Certification
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
Name
Address
State
*
Email
*
First Name
*
Mailing City, State, ZIP
Property Owner Details
Last Name
*
Business Owner Details
Phone #
Phone #
*
Address
*
ZIP
*
Email
City
*
Food - Restaurant
Food - Market Food Vending Machine
Food Truck
Junk Yard
Pet Shop
Private Business
Retail
Salon
Other
Caterer
Deli
Luncheonette
Outdoor Cafe
Bakery
Fish
Grocery
Meat
Produce
Super Market
Yes
No
Last Name
*
Phone #
*
Food Truck Licence Plate #
Block
Restaurant Type (If Applicable)
Address 2
Food Market Type (If Applicable)
Address
Phone #
*
Business Name
*
Name
Business Category (If Other)
Lot
Emergency Contact Details
Was This Business at a Previous Address?
Food Truck Model
Anticipated Start Date
*
Previous Address
Phone #
Business Category
First Name
*
Food Truck Make
Address
Business Details
Tax ID
*
Description
*
Email
Alarm Company Details
Square Feet
Food - Restaurant
Food - Market Food Vending Machine
Food Truck
Junk Yard
Pet Shop
Private Business
Retail
Salon
Other
Existing Business Category
Existing Business Name
Existing Business' Address
Existing Business Description
Phone #
Existing Business Start Date
Existing Business Owner's Tax ID
Existing Use
Existing Business Owner's Name
Address 2
Email
Pay Now
Type Full Name :
Sign With Hand
Clear
Done
Certification
I/we agree the information above is current and correct and if occupancy changes I/we will register new tenants.
*
Your application has been submitted successfully.
Reference Number:
Date Submitted:
Business Name:
Confirmation email sent to: