Fillable APPLICATION FOR BUSINESS LICENSE (City of Huntington Beach)

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APPLICATION FOR BUSINESS LICENSE (City of Huntington Beach)

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U.S.A. forms for City of Huntington Beach

BROWSE CITY OF HUNTINGTON BEACH (CA) FORMS

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CITY OF HUNTINGTON BEACH
FINANCE DEPARTMENT – BUSINESS LICENSE
P. O. Box 190 - 2000 Main Street, Huntington Beach, CA 92648-2702
Phone (714) 536-5267 – Fax (714) 536-5934 – www.huntingtonbeachca.g
ov
APPLICATION FOR BUSINESS LICENSE
BUSINESS DETAILS: Applications must be typed, or legibly hand printed in blue or black inkl
ice
Name of Business (DBA):
Name of Sole Business Owner or Legal Entity(Corporation/LLC/Partnership)
Owner(s) or Principal(s)
Title(s)
Contact Person for Business License
Contact Person’s Direct Phone Number
Business Address
Service of Process Address (Address where business has consented to receive official U.S. Mail)
Business Mailing Address: Check if same as above
Public Business E-mail Address
Public Business Phone
Fax
Type of Ownership (Check One):
Sole Proprietor LLC
Partnership Corporation
Applicable Identification Number (Check One):
Social Security Drivers License _______________________________
Federal Tax ID Municipal ID ID Number
Business Start Date in Huntington Beach (MM/YY)
# Employees (include self):
NAICS CODE
Detailed Description of Business Activity:
Located in a BID?
Yes No
BID Zone
1 2
BID Type or Category
Sq Ftg/Floor/Etc.
BID Fee Amount
Cash Receipt #
Description of Products Sold (If Applicable)
Are you required to collect sales tax?
Yes No
Seller’s Permit (Resale #)
Business Vehicles Used in the City?
Yes No How Many?
Under 1 ton
1-3 tons
Over 3 tons
License Plate #
License Plate #
General Contractor
Sub Contractor
Contractor’s Lic #
Classes
Expiration Date
Job Address
Burglar Alarm System? Yes No
If yes, permit is required. Call (714) 960-8805
Health Permit #
ABC License #
Police Permit #
Finance Permit #
State License (# / Type / Exp. Date)
Live Entertainment? Yes No Sale of Adult Only Items? Yes No
Coin Operated Machines?
Yes No
# Vending
# Amusement
# Service
# Music
# Bulk
Vending Company’s Name/Address/Phone
# Apt/Motel/Rooming House/Office Units
#Trailer Spaces
Date of Purchase
Mobile/Sidewalk Vendor? Yes No
If yes, complete section on back of form
I am aware of the provisions of Section 3700 of the California Labor Code, which requires every employer to be insured against liability for Workers
Compensation. Please check appropriate box:
Certificate of Workers Compensation Insurance
Certificate of Self-Insurance of Workers Compensation
I certify that in the performance of work for which this license is issued I shall not employ any person in any manner so as to become subject to the worker’s compensation
laws of California. Note: If after signing the certificate, you hire any employee, you become subject to the workers’ compensation provisions of the California Labor Code and
you must immediately comply with the provisions of Section 3700 or your license immediately becomes revoked.
In order to obtain a business license, the applicant must present all appropriate zoning permits. Business License applications will not be
accepted or processed by the Business License office until proof of all appropriate zoning permits have been provided.
I hereby declare under penalty of perjury that the information and statements on this application are true and correct.
Signature: ___________________________________________________
Title: ______________________________
Printed Name: ________________________________________________
Date: ______________________________
B/L#
Total Due:
Page 2 of 2
SUPPLEMENTARY INFORMATION REQUIRED: (NON-PUBLIC INFORMATION)
Applications must be typed, or legibly hand printed in blue or black inkl
ice
Owner or Principal
Title
Residence Address
City, State, Zip
Email
Phone
Date of Birth
Social Security # / ID #
Drivers License
Signature
Date
Partner’s Name or Secondary Principal (If applicable)
Title
Residence Address
City, State, Zip
Email
Phone
Date of Birth
Social Security # / ID #
Drivers License
Signature
Date
ALTERNATIVE CONTACT IN CASE OF EMERGENCY:
Name
Title
Phone
MOBILE/SIDEWALK VENDORS ONLY – SUPPLEMENTARY INFORMATION:
Products Sold
Commissary Address (If Applicable)
Previous License?
Yes No
City where previous license obtained / Date
Has license/franchise previously been
revoked/suspended? Yes No
Reason for Suspension if Yes
Year
SIDEWALK VENDORS: CHECK ONE OWNER EMPLOYEE FINANCE PERMIT #
MOBILE VENDORS-VEHICLE INFORMATION
Registered Owner of Vehicle
Description of Logo (may attach photo)
Make of Vehicle
Year
Color
VIN #
MOBILE VENDORS MUST ALSO PROVIDE WITH APPLICATION:
Legible photo copy of valid drivers license for each driver
DMV auto registration
Copy of auto insurance referencing VIN and policy #, naming additionally insured
Color photos of vehicle showing full side profile with logo and full rear of vehicle with license plate
IMPORTANT INFORMATION:
Please notify the Business License Office of any changes to the business, including business name, location, owners, partners, business type or
activity. If the business license is not updated accordingly, it may no longer be valid and the business owner may then be liable for penalties and
administrative citations.
If the business moves to another commercial location, a Certificate of Occupancy for the new location must be applied for with the Planning
Department. Call (714) 536-5271 for application.
As an applicant for a business license, if a Social Security number has been issued to you, then it is required that you provide your Social Security
number as part of the application. Pursuant to Section 405(c)(2)(C)(i) of Title 42 of the United States Code, the City is permitted to require disclosure
of the Social Security number for tax purposes. Disclosure of this information is mandatory. However, while disclosure is required in order for the
City to properly administer the business license tax program, the Social Security number is not public record, and will not be disclosed to any
members of the public.
Under federal and state law, compliance with disability access laws is a serious and significant responsibility that applies to all California building owners and tenants
with buildings open to the public. You may obtain information about your legal obligations and how to comply with disability access laws at the following agencies:
DEPARTMENT OF GENERALSERVICES, Division of the State Architect, CASp Program www.dgs.ca.gov/dsa www.dgs.ca.gov/casp
DEPARTMENT OF REHABILITATION Disability Access Services www.dor.ca.gov www.rehab.cahwnet.gov/ disabilityaccessinfo
DEPARTMENT OF GENERALSERVICES, California Commission on Disability Access www.ccda.ca.gov www.ccda.ca.gov/resourc es-menu
OFFICE USE ONLY:
Bus License #
Entered By:
NOTES:
Reviewed By:
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APPLICATION FOR BUSINESS LICENSE (City of Huntington Beach)

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Completed 4 February 2022

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