THE FOLLOWING FORM IS TO BE
USED BY STATE LICENSED
BUILDING CONTRACTORS DOING
BUSINESS WITHIN THE CITY OF
CITY OF SAN MATEO FOR OFFICE USE
BUSINESS TAX DIVISION Parcel #: ____________________
330 WEST 20TH AVENUE Zone: ____________________
SAN MATEO, CA 94403 Approved/Date: ____________________
(650) 522-7113 Tax Paid: $___________________
Classification #: ____________________
BUILDING CONTRACTOR State Lic. Verified by: ____________________
APPLICATION FOR BUSINESS TAX CERTIFICATE State SB 1186: ____________________
This is not a license to operate.
DATE: __________________________ 10-9811-313401
PLEASE PRINT OR TYPE INFORMATION
*Business Name and Address: Mailing Address (if different from business):
*Phone: _________________________________ (Certificate is mailed to business address for posting.)
*Name of Owners OR Officers of business:
Name Title Address Phone
*Type of Business: ________________________________________________________________________
Federal Tax ID # OR Social Security #:________________________________________________________
Ownership Type: __________ (S = Sole Proprietor, P = Partnership, C = Corporation, T = Trust)
*Contractor's License #: _____________________________
* For State compliance, please either show your Contractors State License Card (if in person) or
attach a copy (if mailing). *
I declare under penalty of perjury, that to the best of my knowledge and belief, the statements made herein are true:
Signature x_____________________________________________ Title _____________________________
Name (Print) ___________________________________________ Date _____________________________
SCHEDULE OF TAXES
TYPE OF BUSINESS Month of Application Submittal
Jan, Apr, Feb, May, Mar, Jun,
Jul, Oct Aug, Nov Sep, Dec
General Contractor (A or B class $125.00 ($124 tax plus $1 $117.00 ($116 tax plus $1 $109.00 ($108 tax plus $1
State Contractors’ License)
State Fee*) State Fee*) State Fee*)
Specialty Contractor (C class State $50.00 ($49 tax plus $1 $47.00 ($46 tax plus $1 State $44.00 ($43 tax plus $1 State
Contractors’ License or Pest control Lic.)
State Fee*) Fee*) Fee*)
1. Enter amount due based on type of business and month of submittal: $__________________.
2. Make checks payable to the City of San Mateo.
3. Enclose a copy of your current Contractor’s State License Card if mailing or show card in person.
4. Send this completed application with your check to:
Business Tax Division
City of San Mateo
330 West 20th Avenue
San Mateo, 94403
New Business Tax Certificate expiration dates are as follows:
Applications processed in Jan, Feb or Mar expire: March 31st of the next year.
Applications processed in Apr, May or Jun expire: June 30th of the next year.
Applications processed in Jul, Aug or Sep expire: September 30 of the next year.
Applications processed in Oct, Nov or Dec expire: December 31st of the next year.
*On September 19, 2012 Governor Brown signed into law SB 1186 which adds a state fee of $1 on any applicant for a
local business tax certificate, or renewal thereof. The purpose is to increase disability access and compliance with
construction-related accessibility requirements and to develop educational resources for businesses in order to facilitate
compliance with federal and state disability laws, as specified.
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.