Fillable CITY OF HANFORD Finance Department (Revize)

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CITY OF HANFORD Finance Department (Revize)

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S:\Finance\PENNY\BUS LIC\FORMS\NEW BUSINESS APP 2018 REV.doc
CITY OF HANFORD – Finance Department
315 N. Douty St., Hanford CA 93230
tel: 559-585-2512, fax: 559-582-1152
Please Check One
NEW APPLICATION
BUSINESS LICENSE APPLICATION
CHANGE OF OWNER
APPLICATION MUST BE COMPLETED AND SIGNED BEFORE LICENSE CAN BE ISSUED, ALONG WITH ALL FEES PAID.
CHANGE OF LOCATION
Business Name (please print-30 characters max)
Business Address
Mailing Address
City, State Zip
City State Zip
Business Phone
Email:
Describe the Profession or Business (20 characters max)
License Start Date
OWNERSHIP Corporation Partnership Sole Proprietor Limited Liability Corporation
GENERAL INFORMATION (Check all that apply)
Adult Oriented Business
Cannabis
Hotel/Motel
Massage Services
Explosives/Ammunition
Restaurant/Fast Food/Convenience Store
Sell or Serve Alcohol
Taxi Service
Car Wash/Automotive Repair
Water Filtration/Resale
Floor Drains
Chemical Processing
Poisonous/Hazardous/Flammable/Compressed
gases, solvents, acids, liquids, or other products.
Non Domestic Wastewater Discharges
Is this a home based business? YES NO
Previous use of this business space?
Federal Employer ID
or Social Security No.
Board of Equalization No.
Contractor’s License#
Enter below names of Owners, Partners, or Corporate Officers – Use additional sheets as necessary
Owner 1
Owner 2
Owner Name
First Last
First Last
Home Address (not PO Box)
City, State, Zip Code
Driver’s License & DOB
Driver License#-State
D.O.B.
Driver License#-State
D.O.B
Title & Contact Telephone
Title
Phone
Title
Phone
The issuance or granting of this Business License shall not be construed to be an approval of any conditions required by other regulatory agencies, departments which if not
complied with may constitute a violation and may prevent or delay business activities. I DECLARE, UNDER PENALTY OF PERJURY, THAT THE INFORMATION
CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT, AND THAT ALL REQUIRED LICENSES ARE IN FULL FORCE AND EFFECT.
SIGNATURE OF OWNER OR REPRESENTATIVE
DATE:
CITY USE ONLY BELOW THIS LINE
PLANNING AUTHORIZATION (Must be completed prior to issuance)
TO BE COMPLETED BY FINANCE DEPARTMENT
Zone District
License Period by Quarter
License/Acct:
Home Occupation Permit No.
(1) JAN - MAR
Expiration Date:
Downtown Business District
YES NO
(2) APR - JUN
Application Fee
Route to
UTILITIES AND ENGINEERING
(3) JUL - SEP
MISC Fee:
POLICE
(4) OCT - DEC
License Fee:
FIRE
Downtown Fee:
APPROVED BY
State Fee:
4.00
DATE
AMOUNT DUE
$
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CITY OF HANFORD Finance Department (Revize)

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Completed 10 July 2021

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