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2. Application For:*

   1. New

   1. Renewal

   1. Bond Expiration
3. License Number
   If you selected "Renewal", please fill in your existing license number here.
5. License Class*

   1. Class A - General ($400)

   1. Class B - Building ($200)

   1. Class C - Residential ($100)
7. Proof of Insurance*
8. Copy of Wichita or Sedgwick County Master License*
12. Name of Business*
13. Business Conducted As:

    1. Individual

    1. Partnership

    1. Corporation
15. Business Address*
17. City*
18. State*
19. Zip Code*
21. Phone Number*
22. Email Address
24. Fax Number
28. Personnel of Business
30. Name
31. Office or Position
33. Name
34. Office or Position
36. Name
37. Office or Position
41. Person(s) Authorized to Obtain Permits and Request Inspections:
43. Name
44. Office or Position
46. Name
47. Office or Position
49. Name
50. Office or Position
52. Name
53. Office or Position
57. Are there any liens, suits, or judgments now pending against you or the business party?*

    1. Yes

    1. No
58. Have you or the organization filed for bankruptcy during the past year?*

    1. Yes

    1. No
60. Who is financially responsible for the business?*
62. Please indicate if you would like to include your company on the Bel Aire website list of licensed contractors. No additional charge.

    1. Yes

    1. No
66. Statement of Agreement
    In submitting this application, it is understood that the applicant whose electronic signature appears below agrees to comply with the provisions of the codes, ordinances, and resolutions applicable and that it is unlawful for a licensee to allow his or her name or license to be used by another, and farther that a license may be revoked for reason of misrepresentation of facts in obtaining such license.
68. Signature (Owner)*
69. Date*
    Date
71. Will you mail your payment to City Hall?

    1. Yes
    2. No

    
    The application's payment by check or money order for the license is to be submitted to:
    City of Bel Aire
    Department of Community Development
    7651 E Central Park Avenue
    Bel Aire, KS 67226
    
72. Would you like to pay over the phone?

    1. Yes
    2. No

    ***Once the application has been reviewed and processed, you will receive a phone call for payment.
Leave This Blank:


78. 1. Receive an email copy of this form.
79. Email address

    This field is not part of the form submission.

80. Submit

* indicates a required field