Cosmetology Facility Permit Application

Cosmetology Facility Permit Application
Establishment Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Owner Name

First NameLast Name
Owner's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
IndividualPartnershipCorporationAssociationOther
Names of all individuals comprising legal ownership and their mailing addresses:

Please note that any permits that are renewed after March 1, 2026 are subject to a late fee 50% of the original permit cost.

Please call TriCounty Health to pay any late fees once the application has been submitted.

My Products

Cosmetology permit fee

$250.00

Total

$0.00