Multi-Service Cosmetology Permit Application

Multi-Service Cosmetology Permit Application
Owner Name

First NameLast Name
IndividualPartnershipCorporationAssociationOther
Provide the name of all individuals comprising legal ownership and their mailing addresses:
Name of person applying for permit

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to establishment
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
Days and Hours of Operation:
Services to be performed:
YesNo
Artist Name

First NameLast Name
What Entity Issued your Business License?
Please Include All Licenses and Certificates Applicable to Facility

Cancelof

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

Body art permit fee

$100.00

Tanning facility permit fee

$100.00

Total

$0.00