Business License Application - City Of Piedmont
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City of Piedmont
New
BUSINESS LICENSE APPLICATION
Renewal
City Clerk’s Office - (510) 420-3040
Business Name _________________________________________________________________________________________
1.
Street _______________________________________________ City __________________________________ Zip _________
Mail Address ________________________________________
City __________________________________ Zip _________
(If different than above)
Owner's Name(s) _______________________________________________________________________________________
2.
Street _________________________________________________ City ___________________________ Zip _________
(If different than above)
Business Phone _________________________________________
Home Phone _________________________________
3.
Type of Business ________________________________________
State Cont. Lic. No. _____________________________
4.
Ownership Type (Check one) Sole Proprietorship ______ Partnership ______ Corporation ______ Trust ______
5.
The State of California requires that you provide at least one of the following:
6.
If you hold a current seller's permit, you MUST list your State Board of Equalization number.
Social Security Number _______________________________
SEIN (State Employer’s ID No.) _____________________
FEIN (Federal Employer's I.D. No.) ______________________
Board of Equalization No. __________________________
N
:
EW LICENSE RATES
State Licensed Contractors (3-Month License)*
$ 50
State Licensed Contractors (12-Month License)*
$100
Film (per day)
$500
Auctions (per day)
$200
All Other Businesses
$100
RENEWAL RATES:
ALL BUSINESSES with gross receipts GREATER than $50,000 for previous year, use the following calculation:
Prior 12 mos. gross receipts $ __________________ x .002 = $________________ (Example: $56,000 x .002 = $112)
Contractors* w/gross receipts less than $25,000 may chose 3-Month License
$ 50 or 12-Month $100
Contractors* w/gross receipts less than $50,000
$100
Film (per day)
$500
Auctions (per day)
$200
Gardeners, chimney sweeps, pest control, craft/art (GROSS < $5,000)
$ 50
Interior design with seller's permit (GROSS < $3,000)
$ 50
All other Businesses w/gross receipts less than $50,000
$100
Effective January 1, 2013, state law (GC § 4467) requires that all applicants for local business licenses add a $1.00 fee to support
state and local disability access programs in addition to the business license tax imposed by the City.
Enclosed is my payment to The City of Piedmont for:
Business License fee:
$_______________________
State Disability Access fee:
$______________1.00 _____
Total
Cash or Check Only
$ _______________________
I hereby certify under penalty of perjury that the information provided in this application is true and correct. Further, I certify I am in
compliance with all applicable state and city ordinances governing my business.
Signature _________________________________________________________
Date ______________________________
*All Licensed Contractors must provide proof of valid Workers’ Compensation insurance as required by State of California.
NO BUSINESS LICENSE WILL BE ISSUED WITHOUT PROOF OF INSURANCE.
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Parent category: Business