CA PERMITS & DESIGN

Designing homes where memories are made.

Business License Request

Contractor Details:

Business Name

State License #

Business Address

Mailing Address (if different than Business Address above)

Leave blank if the same as Business Address above.

Phone

Tax ID or EIN

Ownership Type

Employee Count

Enter the total yearly income from all sales and/or services before any deductions

Estimate if this is a brand new business.

Additional Information

Did you answer "yes" to any of the following:

Yes

Will you buy, sell, take in trade, pawn, take on consignment, or accept for auction or auctioning any tangible personal property?
Will you be serving any alcohol (Beer, Wine or Spirits) in connection with this business?
Will you be serving any food in connection with this business?
Did you receive a letter in the mail regarding your compliance?

City where business license is requested (if more than one, separate with commas)

If more than one, separate with commas.

Acknowledgment:

By submitting this form, I confirm that I’ve read and agree to the Terms & Conditions.

I affirm, under penalty of perjury, that all information I’ve provided on this form is true and correct.

I certify that I have submitted the New Contractor Form and that all information provided is accurate and up to date. I understand that if any information changes after submission, the form must be resubmitted. I also understand that work on a Business License project cannot begin until the completed form has been submitted.