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.