City of Mt. Shasta
305 North Mt. Shasta Blvd - Mt. Shasta, CA. 96067
~ BUSINESS LICENSE APPLICATION ~
Download the entire MT SHASTA BUSINESS LICENSE application from the internet at : (https://mtshastaca.gov/wp/wp-content/uploads/2016/01/businesslicense_packet_2015.pdf)
Or pick up an application at 305 North Mt. Shasta Blvd.
Or call the office at (530) 926 - 7510
_______ DAILY BUSINESS LICENSE
_______ NON PROFIT ORGANIZATION (501C-3) ONLY
NAME OF BUSINESS _______________________
TYPE OF BUSINESS ________________________
Wholesale __ Food ___ Retail ___ Personal Service ___
NAME OF BUSINESS OWNER _________________
BUSINESS ADDRESS ________________________
MAILING ADDRESS ________________________
BUSINESS PHONE __________ CELL ____________
10 X 10 Booth _________ 10 X 20 Booth ________
Number of employees __________ Part time ________
Federal Tax ID Number or Social Security number
________________ - _____________
Owner's Drivers License Number ______________
Signs or banners NONE
Issuance of a business license is solely 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 denials of such approvals prevents the business from operation, so those departments should be contacted before remitting license fees.
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
Signature of Business owner: _______________
OFFICE USE ONLY ______________________________________
Home Occupancy Required _____ Approved _____
Account Number: _______ Date: Receipt #______
Amount Paid ___________ ( includes $1.00 DEA )
Show ______ Park District _____ Class Details _____
Please contact the City Of Mt. Shasta (530) 926 - 7510
For instruction, requirements and information.