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Please note, contractors or consultants not located but working in the city must also register.

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DBA
Business Name
Business Address (Must be physical location, not a Post Office Box)	Verifying Address... Verified! Not recognized as a valid USPS address. Valid USPS address but is missing UNIT/STE #. Valid USPS address but UNIT/STE # is not recognized. Verify Address Edit
Mail Address	Same as address above
	Verifying Address... Verified! Not recognized as a valid USPS address. Valid USPS address but is missing UNIT/STE #. Valid USPS address but UNIT/STE # is not recognized. Verify Address Edit
Please describe your business
Ownership Type	Corporation Ltd Liability Co Ltd Partnership Non Profit Corporation Partnership Sole Proprietorship Trust
Employee Count *
Start Date in City of West Hollywood (estimate if in the future)
Contact Information
Phone
Phone 2
Fax
Website
Email Address
BEAN
FEIN
SEIN
Contact Preference	Contact me by email whenever possible, in order to ensure timely notices and help protect the environment by conserving resources.
State License Information (Contractor, Medical, CAMTC, etc.)
State License #
State License Type
State License Expire Date
State License Verification *
Additional Information
What is the sq. footage of the location you occupy?
What is the maximum occupancy of your business? *
How many full-time employees does your business have? *
How many part-time employees does your business have? *
What was the previous use of the space your business is currently in? *
What was the name of the previous business/tenant? *
What are the days and hours of operation of your business? *
Does your business sell to the general public? *	Yes No
Is your business wholesale only? *	Yes No
Is your business manufacturing only? *	Yes No
Does your business sell / deal guns? *	Yes No
Does your business grow or sell medical marijuana? *	Yes No
Does your business offer motor vehicle rental? *	Yes No
Do you rent / lease your business property? *	Yes No
If yes, who is the property owner? *
Does your business offer massage? *	Yes No
If yes, what is your California Massage Therapy Council Certificate Number?
Do you prepare or sell food for comsumption? *	Yes No
If yes, what is your Public Health Permit Number?
Does your business involve the sale of alcohol? *	Yes No
If yes, what is your ABC license type and number?
Does your business have an outdoor dining area? *	Yes No
If yes, what is the square footage of the area?
Does your business offer valet parking? *	Yes No
If yes, is the parking located onsite or offsite?	---Select---OffsiteOnsite
If offsite, what's the address?
What is the primary Standard Industrial Classification (SIC) Code for this business location?
Is the above SIC code regulated by the NPDES Industrial Activities Stormwater General Permit? *	Yes No
If Yes, provide the NPDES Industrial Activities Stormwater General Permit Identification# assigned by the State Water Resources Control Board to the business.
What is the average management salary? *	---Select---$0 - $25,000$25,001 - $50,000$50,001 - $75,000$75,001 - $100,000Over $100,000
What is the average non-management salary? *	---Select---$0 - $25,000$25,001 - $50,000$50,001 - $75,000$75,001 - $100,000Over $100,000
Is 50% of the business ownership BIPOC? BIPOC stands for Black, Indigenous, and People Of Color. These questions are for informational purposes only and responses do not affect the business tax rate.	Yes No
Affiliated Race/Ethnicity of Business Owner (optional)	---Select---A different ethnic or racial groupAfrican American or BlackAsian or Pacific IslanderCaucasian or WhiteLatino or HispanicNative AmericanPrefer not to answer
# of BIPOC Employees (optional)
# of BIPOC Managers and Above (optional)
Is your business home-based? *	Yes No