Business License Application
Business License Status
| What would you like to do today: |
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| Is this a: |
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| If you are are applying for a Prescott Valley local license, please select which Series you are applying for |
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Business Name and Physical Location
| Business name or Trade Name |
James Agresta Carpentry Inc.
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| Nature of Ownership |
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| Business Street Address (Physical location of the business (cannot be a PO Box) |
689 E 1st ST Prescott Valley, AZ 86314
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| is the business location: |
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| Mailing Address (Street name and number only) |
150 English St
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| Mailing Address City, State, & Zip Code |
Hackensack, NJ 07601
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| Business Phone Number |
+12014981477
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| Number of Employees |
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| Please choose the most applicable to your business: |
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| Please read carefully through the following list and choose the closest description of your business: |
CONTRACTOR GENERAL
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| Business Description (Please describe in detail the nature of the business) |
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| Will your business be selling or serving alcohol? |
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| Start of business date |
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| Locations where the business or applicant has operated during the last 5 years: |
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Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
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| Home Address (No PO Boxes) |
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| Phone number |
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| Driver's License Number |
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| Driver's License Expiration Date |
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| Date of Birth |
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| Social Security Number (Last four (4) digits ONLY) |
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Corporation Information
| State in which the LLC was legally established |
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| Name of the Business (if owned by another entity) |
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| 1. Name (First and Last) |
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| Title |
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| Home Street Address (cannot be a PO Box) |
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| Telephone Number |
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| 2. Name (First and Last) |
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| Title |
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| Home Street Address (cannot be a PO Box) |
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| Telephone Number |
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Federal Tax ID or Social Security Number
| Please enter your Federal Tax ID Number |
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Transaction Privilege Tax (TPT) - Sales Tax
| Please enter your Transaction Privilege Tax (TPT) Number |
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Professional Licenses
| Upload File |
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| Professional License or Permit Number & Description |
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Application Affidavit
Commercial Occupancy Permit
Commercial Occupancy Permit Application- Information
| What business is currently, or has most recently, occupied this business site? |
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| if applicable, what other businesses are located in this building or on this site? |
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| Sq. Ft. of general floor area: |
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| Sq. Ft. of public floor area: |
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Business Information Continued
| Please check any of the following: Will this facility use __________. |
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| Do you or will you store chemicals on site in excess of normal household quantities? |
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| Do you or will you store or use petroleum or non-petroleum oils or greases in your business? |
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| Do you or will you discharge any wastewater (other than domestic wastes from toilets, showers, etc.) to the sewer system? |
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Prescott Valley Police Department Business Identification
| Alarm Company Name and Phone Number |
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| 1. Name and Phone Number of the Responsible Party |
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