Tattoo Permit Application

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The fee for the Tattoo Parlor or Body Piercing Establishment Permit is $200.

Your payment of the fee MUST be completed prior to filling out this form, and you must provide the receipt transaction number to the correct field in this form. Please fill out one form for each establishment. You may combine payments for your establishments, but you must email in the paid receipt after completing this form. Upon completion of this form, you will be provided an email for where you must send a copy of the receipt for your request to be completed.

* Denotes a required field

Establishment Information

Name of Establishment:*

E-mail:

Email addresses are solely used as contact information and will not be shared with 3rd parties.

Establishment Phone:*

Phone Area Code-Phone 3-Phone 4 ext Extension

Address*

Address 2

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Owner Information

Owner Name:*

Address*

Address 2

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Owner Phone:*

Phone Area Code-Phone 3-Phone 4 ext Extension

Biohazard Waste Disposal Company Information

Biohazard Company Name:*

Biohazard Company Phone:*

Phone Area Code-Phone 3-Phone 4 ext Extension

Artist Information (name, address, phone):

Artist 1:

Artist 2:

Artist 3:

Artist 4:

Contact Information in Case of Emergency:*

Go paperless! Please indicate below if you would prefer electronic notification regarding your permit(s):*

Yes, I want paperless transactions:

No, I do not want paperless transactions:

Payment Information

Please Do Not Complete The Following Field

Total Amount Paid to AllPaid:*

AllPaid Transaction Number:*

Tattoo Permit Application

Establishment Information

Owner Information

Biohazard Waste Disposal Company Information

Artist Information (name, address, phone):

Payment Information

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