THE FOLLOWING FORM IS TO BE USED BY STATE LICENSED BUILDING CONTRACTORS DOING BUSINESS WITHIN THE CITY OF SAN MATEO 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. BC 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.
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