Please Check One
BUSINESS LICENSE APPLICATION
New Business License
Address Change
New Location
Ownership Change
Renewal-Exp. Date ___________
Home Occupation
CITY OF ADELANTO
C/O BUSINESS SUPPORT CENTER
8839 N Cedar Ave #212 • Fresno, CA 93720
(760) 298-5461 •
adelanto.hdlgov.com • support@hdlgov.com
FOR OFFICIAL USE ONLY
Business Name
Mailing Address
Description of Business
State Lic. No.
Resale No.
Email Address
State Lic. Type
Federal ID No.
Expire Date
Phone No. Fax No.
Enter below names of Owners, Partners, or Corporate Officers (attach additional sheet if necessary) - Required
In case of emergency, please contact (attach additional sheet if necessary)
Alarm Company (if applicable)
Corporate Name
(if applicable)
Business Location
Corporation
LLP
Partnership
Sole Owner
Non-Profit
1st Owner Name
(Cannot be P.O. Box per State of California Business & Professions Code-Section 17538.5)
Home Address
Title
Date of Birth
Driver Lic. No.
Soc. Sec. No.
Home Phone No.
Contact Name
Address
Phone No.
Company Name License No.
Address
(Cannot be P.O. Box)
Phone No.
Cell / Pager No.
Cell / Pager No.
BUILDING & SAFETY By: _______ Date: ____\____\____
BUSINESS LICENSE By: _______ Date: ____\____\____
CODE ENFORCEMENT
FIRE DEPT By: _______ Date: ____\____\____
POLICE DEPT By: _______ Date: ____\____\____
PLANNING DEPT By: _______ Date: ____\____\____
__________________
Thank you for doing business in the
City of Adelanto!
LLC
Business Location and Information - All fields are required
Business License No.
City State Zipcode
Owner Type - Select one that applies
Other: __________________________________________
Mailing Address - Required
City State Zipcode
City State Zipcode
2nd Owner Name
Home Address
Title
Date of Birth
Driver Lic. No.
Soc. Sec. No.
Home Phone No.
(Cannot be P.O. Box)
Cell / Pager No.
City State Zipcode
RETURN COMPLETED RENEWAL NOTICE &
MAKE CHECK PAYABLE TO:
City of Adelanto • Attn: Business Support Center
8839 N Cedar Ave #212 • Fresno, CA 93720
I hereby certify under penalty of perjury that
the above information is correct and I am
authorized representative of this business. I
understand that this application does not
license me to operate until I have fulfilled all
requirements of the Adelanto Municipal
Code. I agree to conduct all phases of this
business in conformance with all applicable
laws, ordinances and regulations
established for such business/profession.
Signature
Print Name/Title
Date
#
#
#
+
No. of Employees
No. of Units
No. of Vehicles
Receipt # _________ Amount $ _________
Cash
Credit Card
Check # __________
Zoning TUP
Date Received
Comments:
CUP
$1.00
DO NOT OPERATE UNTIL A VALID
LICENSE HAS BEEN ISSUED
THIS IS NOT A BUSINESS LICENSE
__________________________________
By: _______ Date: ____\____\____
By: _______ Date: ____\____\____
Business Start Date
Please provide the following information that pertains to
your business or any business activity that will be
conducted within the City of Adelanto.
click to sign
signature
click to edit
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