Fillable BUSINESS LICENSE APPLICATION Regular Business License Daily License (City of Mt Shasta)

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BUSINESS LICENSE APPLICATION Regular Business License Daily License (City of Mt Shasta)

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U.S.A. forms for City of Mt Shasta

BROWSE CITY OF MT SHASTA (CA) FORMS

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BUSINESS LICENSE APPLICATION
CITY OF MT. SHASTA
305 N. MT. SHASTA BOULEVARD
MT. SHASTA, CALIFORNIA 96067
(530) 926-7510
Regular Business License Daily License ($19/day or $139/qtr) Peddler/Solicitor
Seasonal/Quarterly - Licensed Contractors Only
Door to Door Fixed Mobile Mobile
Non-Profit Organization (501c3 required)
Other
(Specify)__________________________
NAME OF BUSINESS:_____________________________________________________________________
NAME OF BUSINESS OWNERS:___________________________________________________________
BUSINESS ADDRESS:_____________________________________________________________________
MAILING ADDRESS (IF DIFFERENT):______________________________________________________
EMAIL ADDRESS:_________________________________________________________________________
BUSINESS TELEPHONE:______________________ PERSONAL/CELL PHONE:___________________
TYPE OF BUSINESS:______________________________________________________________________
WHOLESALE RETAIL PERSONAL SERVICES
FOOD SERVICE NUMBER OF SEATS _________
MOTEL/HOTEL NUMBER OF ROOMS ________
RENTALS NUMBER OF RENTAL UNITS ________
OTHER SPECIFY ______________________________________________________
SQ. FT. OF BUSINESS FLOOR - Parking District, Only (See map): _______________________________
NUMBER OF ON-SITE PAVED PARKING SPACES - Parking District, Only (See map): ____________
NUMBER OF LOCAL FULL-TIME EMPLOYEES: ______________ PART-TIME: ________________
FEDERAL TAX ID OR SOCIAL SECURITY NUMBER:________________________________________
OWNER’S DRIVERS LICENSE NO.__________________ ISSUING STATE ____ EXPIRES: _________
STATE BOARD SELLERS PERMIT NO._____________________________________________________
STATE CONTRACTORS LICENSE NO.: _____________________________________________________
Are any signs or banners anticipated? Yes* No
*If yes, you are required to obtain a Sign Permit. If you fail to do so, you may be subject to fines &
penalties.
Specify months of operation _______________
Issuance of a business license is intended soley as evidence that the required tax has been paid, and does
not indicate approval to operate said business if Planning, Health, or Building Department approvals are
required for the proposed operations and/or location. No refunds will be made if denial of such approvals
prevents the business from operation, so those departments should be contacted before remitting license
fees.
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE
IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE OF BUSINESS OWNER:________________________________________________________
OFFICE USE ONLY
HOME OCCUPATION PERMIT. REQUIRED:. __________ APPROVED:_____________________________
Date Received/Opened:_____________ Receipt #_______________Amount Paid $__________+ 4.00 DAE
(PLEASE SEE REVERSE FOR INSTRUCTIONS AND APPROVAL REQUIREMENTS)
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BUSINESS LICENSE APPLICATION Regular Business License Daily License (City of Mt Shasta)

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Completed 14 July 2020

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