Town Of Prescott Valley Business License Division

Commercial Occupancy

May 09, 2022
submission #157
Business License Application

Business License Status

What would you like to do today: ---
Is this a: ---
If you are are applying for a Prescott Valley local license, please select which Series you are applying for ---

Business Name and Physical Location

Business name or Trade Name Liberty General Contracting 989 S Main St Ste A-471 Cottonwood, AZ 86326-4602
Nature of Ownership ---
Business Street Address (Physical location of the business (cannot be a PO Box) 565 E Breezy Knoll Ln, Cottonwood, AZ 86326
is the business location: ---
Mailing Address (Street name and number only) 989 S Main St Ste A-471
Mailing Address City, State, & Zip Code Cottonwood, AZ 86326-4602
Business Phone Number +19283008673
Number of Employees ---
Please choose the most applicable to your business: ---
Please read carefully through the following list and choose the closest description of your business: CONTRACTOR GENERAL
Business Description (Please describe in detail the nature of the business) ---
Will your business be selling or serving alcohol? ---
Start of business date ---
Locations where the business or applicant has operated during the last 5 years: ---

Applicant Information (Must be completed by the person filling out this application)

Name (First and Last) ---
Home Address (No PO Boxes) ---
Phone number ---
Social Security Number (Last four (4) digits ONLY) ---

LLC Ownership Information

State in which the LLC was legally established ---

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number ---

Professional Licenses

Professional License or Permit Number & Description ---

Application Affidavit

Applicant Affidavit ---