HomeMy WebLinkAboutBusiness License Application Updated 11222023• Business Licensing Division •
8839 N Cedar Ave #212, Fresno, California 93720
PH 442-325-3954 • FAX (909) 348-0465
City of Palm Desert
Business License Application
OFFICIAL USE ONLY
Business License No.
Expiration Date
NAIC Code
License Fee $
Check #q Credit Card q Cash
Corporate Name
(if applicable)
Phone No.
(Cannot be P.O. Box)Other ID No.
Home Address
q Trustq Sole Proprietorq Partnershipq Corp-Ltd Liabilityq CorporationOwnership
PERSONAL INFORMATION - Enter below names of Owners, Partners, or Corporate Officers (attach additional sheet, if necessary)
Phone No.
(Cannot be P.O. Box)Other ID No.
Home Address
Alt. No.Phone No.Expire Date
PLEASE TYPE OR PRINT WITH PEN
q New Application
Social Security No.Title
Social Security No.Title
2nd Owner Name
(Cannot be P.O. Box per State of California Business & Professions Code-Section 17538.5)
1st Owner Name
Business Location
Bus. Start Date
State ID No.
Federal ID No.
q Change
State Sales Tax No.
State License No.
Description of Business
Mailing Address
Business Name
q Non-Profit
q Home Occupation
Email Address
State License Type
Driver's License No.
Driver's License No.
Have you filed a
Fictitious
Business Name
Statement?
q Noq Yes
Per AB 2184, you may protect your residential address by providing a different Service of Process address in accordance with Sections 16000.1(a)(2)
and 16100.1(a)(2) of the Business and Professions Code. To do so, please fill out the section on the back of this form
*THE INFORMATION BELOW MUST BE COMPLETED FOR YOUR BUSINESS LICENSE TO BE PROCESSED*
The City of Palm Desert business license application has been updated in accordance with California Senate Bill No. 205. The primary Standard Industrial Classification (SIC)
code, identifying the primary activity of your business, must now be provided with your renewal, and your subjectivity to the State’s Industrial General Permit (IGP) must be
evaluated as part of this process. Please complete section 2 inPage 2 to fulfill this new requirement.
Signature of Owner or Representative
CERTIFICATION AND ACKNOWLEDGEMENT
I declare under penalty of perjury that the statements
made in this application are true. I further agree that
business shall be conducted in accordance with the City
of Palm Desert Municipal Code. I understand that Sales
or Use Tax may apply to my business activities. Upon
issuance of a Business License, it shall be my
responsibility to renew the license before the end of
anniversary month.
Title
Thank you for doing business
in the City of Palm Desert
Name
Address
Title
Date
SIGN HERE
EMERGENCY NOTIFICATION - In case of emergency and I cannot be reached, please call:
Phone No.
PLEASE FILL IN THE APPROPRIATE BOXES BELOW AND SIGN Business License Application Fees
NOTICE: Under federal and state law, compliance with disability access laws is a serious and
significant responsibility that applies to all California building owners and tenants with buildings open
to the public. You may obtain information about your legal obligations and how to comply with
disability access laws at the following agencies: The Division of the State Architect at
www.dgs.ca.gov/dsa - The Department of Rehabilitation at www.dor.ca.gov - The California
Commission on Disability Access at www.ccda.ca.gov.
RETURN APPLICATION BY MAIL TO:
City of Palm Desert - Business Licensing
8839 N. Cedar Ave #212
Fresno, CA 93720-1832
SCAN & RETURN APPLICATION BY EMAIL TO:
Palmdesert@HdLgov.com
SF
Sq. ft. of business
if in city limits
$
#No. of
Owners/Employees#
Estimated First Year Annual Gross Receipts (GR) for
Sales and/or Services
No. of Residential
Rental Units
SERVICE OF PROCESS ADDRESS, PURSUANT TO AB 2184 - AVAILABLE FOR PUBLIC INSPECTION
If you wish to protect your residential address with a different service of process address, please provide it here.
NOTE - if your service of process address is a post office box or private mailbox, it must comply with paragraph (2) of subdivision (b) of Section
17538.5 of the California Business and Professions Code.
Service of Process Address
Residential Address to protect q Business Location q Mailing Address q Owner/Partner/Officer Address
NPDES PERMIT PROGRAM, PURSUANT TO SB 205 - STORMWATER DISCHARGE
*If you are a business that is a regulated industry with storm water discharge requirements in accordance with the SB 205 NPDES permit program, please complete the
following:
SIC #Permit #
*Otherwise, please provide the following identification numbers:
Notice of Non-Applicability # No Exposure Certification #OR
If you do not have an SIC number or a Permit number, or if you are unaware of the requirement, please contact the State Water Resources Control Board at
www.waterboards.ca.gov/water_issues/programs/stormwater/contact.html. The State Water Resources Control Board will issue your "Water Discharge Identification
Number", "Notice of Non-Applicability" identification number, or "No Exposure Certification" identification number