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Annual Food Permit Payment Form (no late fees)

  1. SJCHD logoCMYK
  2. Annual Food Permit Payment Form
    Please complete this form after you have submitted your renewal application through DocuSign.
  3. You must list all the business addresses for all the permits you are paying for at this time. For example, if you have 3 locations, you can fill out 3 applications through DocuSign, and then use this one payment form to pay for all three applications. Just list all three business location addresses.
  4. Gross Sales between $0.00 and $49,999.99
    $75 Annual Permit
  5. Price
  6. Gross Sales between $50,000.00 and $149,999.99
    $100 Annual Permit
  7. Price
  8. Gross Sales between $150,000.00 and $249,999.99
    $125 Annual Permit
  9. Price
  10. Gross Sales between $250,000.00 and $499,999.99
    $150 Annual Permit
  11. Price
  12. Gross Sales between $500,000.00 and $749.999.99
    $200 Annual Permit
  13. Price
  14. Gross Sales between $750,000.00 and $999,999.99
    $250 Annual Permit
  15. Price
  16. Gross Sales between $1,000,000.00 and $1,249,999.99
    $300 Annual Permit
  17. Price
  18. Gross Sales between $1,250,000.00 and $1,499,999.00
    $325 Annual Permit
  19. Price
  20. Gross Sales over $1,500,000.00
    $375 Annual Permit
  21. Price
  22. Initial Administrative Fee
    if applicable
  23. Price
  24. Online Payment Fees:
    Online payments are processed by Forte. A fee of 2.5% or $1.50 (whichever is greater) will be assessed for all credit card payments. Electronic Checks are also accepted, and will be assessed a flat $1.25 for any payment under $50,000. The appropriate fee will be added to the total cost of your payment.
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