Town Of Prescott Valley Business License Division

Commercial Occupancy Application

Jan 25, 2023
submission #1152
Business License Application

Business License Status

What would you like to do today: ---
Is this a: ---
If you are are applying for or renewing a PV liquor License, please select which Series you are applying for ---

Business Name and Physical Location

Business name or Trade Name Amadora Salon &boutique
Nature of Ownership ---
Business Street Address (Physical location of the business (cannot be a PO Box) 7579 Addis Ave
is the business location: ---
Mailing Address (Street name and number only) 7579 Addis Ave
Mailing Address City, State, & Zip Code Prescott Valley Az 86314
Business Phone Number +19287720888
Alternate # (Emergency Phone Number) ---
Number of Employees ---
Please choose the most applicable to your business: ---
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 ---
Driver's License Number ---
Date of Birth ---
Social Security Number (Last four (4) digits ONLY) ---

Partnership

1. Partner/Owner (First and Last Name) ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---
Social Security Number (Last four (4) digits only) ---
2. Partner/Owner (First and Last Name) ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---
Social Security Number (Last four (4) digits only) ---