city of covina official use onlyofficial use only return application by mail to: city of covina –...

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OFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION BY E-MAIL TO: support@hdlgov.com 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/Home.aspx - The Department of Rehabilitation at www.rehab.cahwnet.gov - The California Commission on Disability Access at www.ccda.ca.gov. Apply Online Today At: http://covina.hdlgov.com BUSINESS LICENSE APPLICATION Business License No. Expiration Date NAIC Code License Fee $ Corporate Name (if applicable) (Cannot be P.O. Box) Home Address Trust Sole Proprietor Partnership Corp-Ltd Liability Corporation Ownership PERSONAL INFORMATION - Enter below names of Owners, Partners, or Corporate Officers (attach additional sheet, if necessary) (Cannot be P.O. Box) Home Address Alt. No. Primary Phone No. PLEASE TYPE OR PRINT WITH PEN New Application Social Security No. Title 2nd Owner Name 1st Owner Name Business Location (Cannot be P.O. Box ) Bus. Start Date Change Description of Business Mailing Address Business Name Non-Profit Home Occupation Social Security No. Home Phone No. Cell Phone No. Title Thank you for doing business in the City of Covina! Title Application Date Phone No. Cell Phone No. City of Covina Business Support Center Phone: (626) 384-5512 F.A.X: 909-348-0465 Mailing Address: 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 Business Cell Home Business Cell Home Federal ID No. Email Address STREET STREET CITY CITY STATE STATE ZIP CODE ZIP CODE EMERGENCY NOTIFICATION - In case of emergency and I cannot be reached, please call: Name Address CONTRACTORS - This section is required for all contractors. Please provide the no. of employees working within the City of Covina as well as any other requested information. Contractor's State License Number Expiration Date No. of Full Time Employees No. of Part Time Employees Home Phone No. Cell Phone No. Title PLEASE FILL IN THE APPROPRIATE BOXES BELOW AND SIGN CERTIFICATION AND ACKNOWLEDGEMENT I acknowledge that the City of Covina's issuance of a Business License and payment of Business License Tax does not entitle me/authorized representative to conduct any business in the City that is in violation of any applicable laws. I further acknowledge that the City of Covina's issuance of a Business License does not waive the City of Covina's right in any way to enforce compliance with applicable laws against me/authorized representative. I hereby declare under the penalty of perjury that to the best of my knowledge and belief the statements made on this application are true and correct. SIGNATURE PRINT NAME

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Page 1: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION

OFFICIAL USE ONLY

RETURN APPLICATION BY MAIL TO:

City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832

SCAN & RETURN APPLICATION BY E-MAIL TO:

[email protected]

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/Home.aspx - The Department of Rehabilitation at www.rehab.cahwnet.gov - The California Commission on Disability Access at

www.ccda.ca.gov.

Apply Online Today At: http://covina.hdlgov.com

BUSINESS LICENSE APPLICATION

Business License No.

Expiration Date

NAIC Code

License Fee $

Corporate Name (if applicable)

(Cannot be P.O. Box)

Home Address

Trust Sole Proprietor Partnership Corp-Ltd Liability Corporation Ownership

PERSONAL INFORMATION - Enter below names of Owners, Partners, or Corporate Officers (attach additional sheet, if necessary)

(Cannot be P.O. Box)

Home Address

Alt. No. Primary Phone No.

PLEASE TYPE OR PRINT WITH PEN

New Application

Social Security No. Title

2nd Owner Name

1st Owner Name

Business Location (Cannot be P.O. Box )

Bus. Start Date

Change

Description of Business

Mailing Address

Business Name

Non-Profit

Home Occupation

Social Security No.

Home Phone No.

Cell Phone No.

Title

Thank you for doing business in the City of Covina!

Title

Application Date

Phone No.

Cell Phone No.

City of CovinaBusiness Support Center

Phone: (626) 384-5512 • F.A.X: 909-348-0465Mailing Address: 8839 N. Cedar Ave #212 • Fresno, CA 93720-1832

BusinessCellHome

BusinessCellHome

Federal ID No.Email Address

STREET

STREET

CITY

CITY

STATE

STATE

ZIP CODE

ZIP CODE

EMERGENCY NOTIFICATION - In case of emergency and I cannot be reached, please call:

Name

Address

CONTRACTORS - This section is required for all contractors. Please provide the no. of employees working within the City of Covina as well as any other requested information.

Contractor's State License Number Expiration Date

No. of Full Time Employees

No. of Part Time Employees

Home Phone No.

Cell Phone No.

Title

PLEASE FILL IN THE APPROPRIATE BOXES BELOW AND SIGN

CERTIFICATION AND ACKNOWLEDGEMENT I acknowledge that the City of Covina's issuance of a Business License and payment of Business License Tax does not entitle me/authorized representative to conduct any business in the City that is in violation of any applicable laws. I further acknowledge that the City of Covina's issuance of a Business License does not waive the City of Covina's right in any way to enforce compliance with applicable laws against me/authorized representative. I hereby declare under the penalty of perjury that to the best of my knowledge and belief the statements made on this application are true and correct.

SIGNATURE

PRINT NAME

Page 2: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION
Page 3: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION
Page 4: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION
Page 5: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION
Page 6: City of Covina OFFICIAL USE ONLYOFFICIAL USE ONLY RETURN APPLICATION BY MAIL TO: City of Covina – Business Licensing 8839 N. Cedar Ave #212 Fresno, CA 93720-1832 SCAN & RETURN APPLICATION

BUSINESS LICENSE INFORMATIONAL PACKET

ENCLOSED WITHIN THIS INFORMATIONAL PACKET ARE DEPARTMENTAL AND OUTSIDE AGENCY FORMS, INCLUDING CONTACT INFORMATION, NECESSARY TO ASSIST YOU THROUGH THE BUSINESS LICENSE SUBMITTAL PROCESS. SHOULD YOU HAVE ANY QUESTIONS REGARDING THE BUSINESS LICENSE SUBMITTAL PROCESS, PLEASE CONTACT HDL COMPANIES OR THE CITY OF COVINA FINANCE DEPARTMENT (SEE BELOW). THANK YOU AND WELCOME TO THE CITY OF COVINA.

☐ HDL Companies 8839 N. Cedar Avenue, No. 212 Fresno, CA 93720 (626) 384-5512 Email: [email protected]

☐ Finance Department – Office overseeing HDL Company Services 125 E. College Street Covina, CA 91723 (626) 384-5506

☐ Covina Police Department – Alarm Services (Form attached) 444 N. Citrus Avenue Covina, CA 91723 (626) 331-3391 • All alarm customers and their alarm company MUST

register their alarm system • Alarm Permit Renewals • False Alarm Billing

☐ Covina Public Works Department - Environmental Services Division 125 E. College Street Covina, CA 91723 (626) 384-5480 Examples: • Grease interceptors • Stormwater • Solid waste/refuse

☐ County of Los Angeles Fire Department – East Region Covina Fire Prevention, Fire Station 154 (Form attached) 400 N. Citrus Avenue Covina, CA 90723 (626) 974-8335 Office Hours: 7:30-10:30 am (M-Th) Examples: • High-piled combustible storage • Hazardous materials • Combustible materials • Refrigeration • Place of assembly • Dry Cleaning equipment • Spray booth • Repair garage • Industrial baking oven, etc.

☐ County of Los Angeles Health Department 5050 Commerce Drive Baldwin Park, CA (626) 430-5100 • Cottage Food Business – Refer to Covina Municipal

Code (CMC) Section 17.26.035(O) attached. • All commercial food and restaurants

☐ Covina Planning Division – Zoning Information 125 E. College Street Covina, CA 91723 (626) 384-5450 Counter Hours: 7:00 – 1:00 pm (M-Th, Closed Fridays)