Tattoo Parlor Permit Application

Establishment Name
Trade Name or Doing Business as Name (DBA)

Address

City

State

Zip Code

First Name

Last Name

Address

City

State

Zip Code

Phone Number

Email

What is Your Date of Birth?

What is Your Place of Birth?

Do You Have a Past Employer?
- select - Yes No

Past Employer
Manager/Supervisor First & Last Name, Business/Company Name, Address, City, State, Zip Code, Phone Number & Email

Do You Have Another Past Employer?
- select - Yes No

Past Employer
Manager/Supervisor First & Last Name, Business/Company Name, Address, City, State, Zip Code, Phone Number & Email

Do You Have Another Past Employer?
- select - Yes No

Past Employer
Manager/Supervisor First & Last Name, Business/Company Name, Address, City, State, Zip Code, Phone Number & Email

Number of Chairs?

Start Time
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Closing Time
1 2 3 4 5 6 7 8 9 10 11 12 : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 AM PM

Has Any Previous Business, or Occupational License Including Any Alcoholic Beverage And Tattoo Parlor License Been Revoked?
- select - Yes No

If yes, please state the reason for the revocation.

Any Previous Business or Occupational License, If Yes Please Attach The License.
- select - Yes No

Do You Have Any Facts Relevant to the General Personal History of the Applicant as The BPS Shall Find Necessary to a Fair Determination of the Applicant's Eligibility For a License?
If so, Please Attach an Additional Sheet
- select - Yes No

Detailed Description of Work

We accept .gif,.jpg,.jpeg,.png,.tiff,.bmp,.pdf,.txt,.rtf,.csv,.doc,.docx,.xls,.xlsx,.ppt,.pptx, .zip files under 50 MB.

The system allows you to upload a maximum of 20 documents with your application. You may upload more documents via case manager after you submit.

Add another related document

I hereby consent to the stipulated conditions.
Tattoo Parlor Permit Conditions

Enter Full Legal Name