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.gov
APPLICATION FOR TEMPORARY BUSINESS LICENSE
FOR SPECIAL OR SPECIFIC EVENTS
PLEASE COMPLETE ALL APPLICABLE SECTIONS: Applications must be typed, or legibly hand printed in blue or black ink
Please check all that apply: Event Organizer Single Vendor Non-Profit Org. Blanket License July 4th Film Crew
Mailing Address; City, State, Zip
Description of Activity at Event
# Booths / Vendors you will have at event:
(Organizer to provide list of booths/vendors)
# Businesses providing a service at the event:
(Organizer to provide list of service providers)
Approx. number
of staff at event:
Sellers Permit (Resale #)
Health Permit? Yes No Liquor License? Yes No
Non-Profit or Charitable Organization? Yes No
Name of Corporation (if different)
Check documents attached.
501(c)(3) Articles of Incorporation as a Non-Profit/Charitable Organization
Written approval of non-profit status from IRS Written approval of non-profit status from State Franchise Tax Board
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.
I hereby declare under penalty of perjury that the information and statements on this application are true and correct.
Signature: ___________________________________________________
Title: ______________________________
Printed Name: ________________________________________________ Date: ______________________________
