HomeMy WebLinkAboutOne Day Business License Updated 2212024Insurance Information
CITY OF PALM DESERT
ONE-DAY BUSINESS LICENSE APPLICATION
EVENT NAME: DATE:
Please TYPE or PRINT CLEARLY
Business Name/Owner
Type of Business
Business Address
City State Zip
Applicant Phone Number
Mailing Address Zip
Email Address TUP#____________________________________________
Worker's Comp. No. Exp.
Insurance. Name Certificate of Self-Insurance
Insurance Waiver: Yes No
I hereby certify that all information I supplied is correct and that any licenses required by the County, State, or Federal
Government issued to me are in full force and effect.
Applicant Signature Title Date
Account. No. Description Fees
Base License Flat Fee $ 29.00
BL 110-0000-316-6000BD 110-0000-314-9600
EL 271-0000-355-3000
$
$
$
Total Fees Collected: $ 29.00
Mail to: City of Palm Desert Attn: Code Compliance
73-510 Fred Waring Drive Palm Desert, CA 92260 (760) 346-0611