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2. 

3. This is a registration form for all business owners to fill out for the Commercial Business Inspection Program (CBIP). This program began 1/1/2021 and it's mission is to provide safe and sanitary commercial property conditions for the residents of Newton by establishing minimum standards and regular inspections for all commercial properties in Newton. If you have any questions please contact the Newton Fire Department (641) 792-3347

5. DATE:
   DATE:
7. BUSINESS NAME:*
9. BUSINESS ADDRESS:*
11. TOTAL NUMBER OF UNITS:
13. BUSINESS OWNER NAME:*
15. BUSINESS OWNER MAILING ADDRESS:*

    If different from business location address

16. Apt #
18. City
19. State
20. Zip
22. BUSINESS PHONE NUMBER
23. HOME OR CELL PHONE NUMBER
25. EMAIL:*
27. SECONDARY CONTACT (PROPERTY OWNER)

    This will be contact information for the property owner, if the property and business are owned and managed by the same individual, this section can be skipped

29. PROPERTY OWNER NAME:
31. PROPERTY OWNER PHONE NUMBER
32. EMAIL:*
34. OWNER OR SECONDARY CONTACT MUST BE AVAILABLE IN CASE OF EMERGENCY
    I hereby apply for a City of Newton Commercial Business/Property occupancy permit for the above described property. I understand that the issuance of a permit does not imply that the above commercial business/property complies with the requirements of the City of Newton Commercial Business/Property Code and that the permit may be revoked if, after inspection, it is found that the business/property does not substantially comply with the provisions of the Property Code. I agree to notify the Newton Fire Department within thirty (30) days of any change in address, phone number or secondary contact information.
36. Certification and Electronic Signature
    By clicking I agree below, you agree and acknowledge that 1) Your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature and 3) You hereby certify that you have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.
38. Do you agree?*

    1. I agree
42. TOTAL UNITS
43. X $25.00 REGISTRATION FEE = TOTAL
45. PAY ONLINE
    Commercial Business Registration ePay

    Note - A 3.95% convenience fee for online payment processing will be added at checkout.

47. PAY BY CHECK

    1. I plan to pay by check/money order/cash.

    Make checks payable to: City of Newton 410 S 2nd Ave W Newton, Iowa 50208

49. Property shall pass Commercial Business/Property Inspection prior to permit being issued.

    APPLICATION AND PAYMENT DUE WITHIN THIRTY (30) DAYS

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit Submit and Print

* indicates a required field